National Vital Statistics System

26. Characteristics of labor and delivery

Category: Labor and Delivery

BC # 45

Definitions, Instructions, Sources, Keywords and Abbreviations
Definitions Information about the course of labor and delivery.
Instructions Check all characteristics that apply.

If none of the characteristics of labor and delivery apply, check “none of the above.”

Sources See below
Keywords and Abbreviations

See below

Induction of labor
Definitions

Initiation of uterine contractions by medical or surgical means for the purpose of delivery before the spontaneous onset of labor (i.e., before labor has begun).

Examples of methods include, but are not limited to: artificial rupture of membranes, balloons, oxytocin, prostaglandin, luminaria , or other cervical ripening agents.

Instructions

Check this item if medication was given or procedures to induce labor were performed before labor began. If it is not clear whether medication or procedures were performed before or after labor had begun, review records to determine when labor began and when medications were given or procedures performed. If this information is unclear or unavailable, check with the birth attendant.

Induction of labor should be checked even if the attempt to initiate labor is not successful or the induction follows a spontaneous rupture of the membrane without contractions.

NOTE: Does not include augmentation of labor, which applies only after labor or contractions have begun. Do not report augmentation of labor if induction of labor is reported.

Sources

1st  Delivery record under

  • Maternal OB/labor summary
  • Labor and delivery admission history
  • Labor summary record

2nd  Physician progress note

3rd  Labor and delivery nursing admission triage form

Keywords and Abbreviations

IOL – Induction of labor

Pit Ind – Pitocin induction

ROM/NIL – Amniotomy induction
or induction for rupture of
membranes, not in labor

AROM – Artificial rupture of membranes done before labor

Balloons

Oxytocin

Prostaglandin

Luminaria

Cervidil

Augmentation of labor
Definitions Stimulation of uterine contractions by drug or manipulative technique with the intent to reduce the time of delivery (i.e., after labor has begun).
Instructions

Check this item if medication was given or procedures to augment labor were performed after labor began. If it is not clear whether medication or procedures were performed before or after labor had begun, review records to determine when labor began and when medications were given or procedures performed. If this information is unclear or unavailable, check with the birth attendant.

NOTE: Do not include if induction of labor was performed. Do not report induction of labor if augmentation of labor is reported.

Sources

1st  Delivery record under

  • Maternal OB/labor summary
  • Labor and delivery admission history
  • Labor summary record

2nd  Physician progress note

Keywords and Abbreviations

Pit stim – Pitocin stimulation

Pit aug – Pit augmentation

AROM – Artificial rupture of membranes done during labor

Cervidil

Steroids (glucocorticoids) for fetal lung maturation received by the mother before delivery.
Definitions Steroids received by the mother prior to delivery to accelerate fetal lung maturation. Typically administered in anticipation of preterm (less than 37 completed weeks of gestation) delivery.

Steroids include: betamethasone, dexamethasone, or hydrocortisone specifically given to accelerate fetal lung maturation.

Does not include steroid medication given to the mother for anti-inflammatory treatment before or after delivery.

Instructions

Three conditions must be met for this item . Check this item when 1) steroid medication was given to the mother 2) prior to delivery 3) for fetal lung maturation.

Steroids may be administered to the mother prior to admittance to the hospital for delivery . Review the mother’s prenatal care and other hospital records for mention of steroid administration for this purpose.

Sources

1st Delivery record under

  • Maternal OB/labor summary–comments
  • Labor summary record–comments

2nd Maternal medication record

3rd Newborn admission history and physical (H&P)

4th Maternal physician order sheet

5th Prenatal care records

Keywords and Abbreviations

Medications (before delivery):

Betamethosone (Celestone)

Betamethasone phosphate

Beta-PO4

Betamethasone acetate

Beta-Ac

Dexamethasone

BMZ

Antibiotics received by the mother during delivery
Definitions

Includes antibacterial medications given systemically (intravenous or intramuscular) to the mother in the interval between the onset of labor and the actual delivery.

Includes:

  • Ampicillin
  • Penicillin
  • Clindamycin
  • Erythromycin
  • Gentamicin
  • Cefataxine
  • Ceftriaxone
Instructions Mother should have undergone labor, regardless of method of delivery; antibiotics administered solely for surgery such as cesarean delivery should not be reported.

Check the timing of the administration of the antibacterial medications. Check this item only if medications were received systemically by the mother during labor. If information on onset of labor cannot be determined from the records, check with the birth attendant.

Sources

1st Delivery record under

  • Maternal OB/labor summary–comments
  • Labor summary record–comments

2nd Maternal medication record

3rd Newborn admission history and physical (H&P)

4th Maternal physician order sheet

5th Prenatal care records

Keywords and Abbreviations

Medications (during delivery):

  • Ampicillin
  • Penicillin
  • Clindamycin
  • Erythromycin
  • Gentamicin
  • Cefataxine
  • Ceftriaxone
  • Vancomycin

Look for:

  • SBE (sub-acute bacterial endocarditis) prophylaxis
  • GBS positive or GBS + (Group B streptococcus)
  • Maternal fever
  • Mother febrile
Clinical chorioamnionitis diagnosed during labor or maternal temperature greater than or equal to 38° C (100.4°F)
Definitions

Clinical diagnosis of chorioamnionitis during labor made by the delivery attendant.

Usually includes more than one of the following: fever, uterine tenderness or irritability, leukocytosis, fetal tachycardia, maternal tachycardia, or malodorous vaginal discharge.

Any recorded maternal temperature at or above 38°C (100.4°F).

Instructions

Check that recorded maternal temperature is at or above 38°C (100.4°F).

Sources 1st  Delivery record under
  • Maternal OB/labor summary – comments/complications
  • Labor summary record – comments/complications

2nd  Newborn admission H&P

3rd  Physician progress note

4th  Maternal vital signs record under – Temperature
recordings

Keywords and Abbreviations

Chorioamnionitis

Chorio

Temp ≥ 38°C or 100.4°F

Look for:

  • Maternal fever
  • Mother febrile

Epidural or spinal anesthesia during labor
Definitions

Administration to the mother of a regional anesthetic to control the pain of labor.

Delivery of the agent into a limited space with the distribution of the analgesic effect limited to the lower body.

Instructions Mother should have undergone labor, regardless of method of delivery; anesthesia administered solely for surgery such as cesarean delivery should not be reported.
Sources 1st  Delivery record under
  • Maternal OB labor summary under – analgesia or anesthesia
  • Labor summary record under – analgesia or anesthesia
Keywords and Abbreviations

Epidural analgesia

Epid. given

Spinal given

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