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Perinatal and maternal outcomes at term in low-risk pregnancies according to NICE criteria: comparison between a tertiary obstetrical hospital and midwife-attended units



The aim of this study was to evaluate the perinatal and maternal outcomes at term at a single tertiary, university hospital in women with low-risk pregnancies.

Patients and methods

We performed a retrospective cohort study of women with low-risk pregnancies, who delivered at University Women’s Hospital Magdeburg between January 2010 and December 2014. Data were compared with data published by Brocklehurst et al. 2011.


Of the 6052 women investigated, 2014 were classified as low risk according to the NICE criteria and were eligible for analysis. In 94.8%, a spontaneous vertex birth was observed. There were only 2 (0.1%) perinatal complications and 52 (2.5%) maternal complications. Ventouse delivery, forceps delivery, and caesarean sections were performed in 2.5, 1, and 3.1% of the cases, respectively. Episiotomy was performed in 37.7% of women. The third and fourth degree perineal trauma were observed in 0.3% of births investigated. Complications during the third stage of labour and blood transfusions were observed in 0.25 and 0.2%, respectively. In comparison with the births at home, we had lower rate of fetal complications for nulliparous women, but not for multiparous women, lower rate for blood transfusions, third and fourth degree perineal trauma and forceps delivery, and higher rate of spontaneous vertex birth, epidural analgesia, and episiotomy. The rate of vacuum extractions and caesarean sections were similar between both the places of birth.


The tertiary-level obstetric unit is safe place of birth for women with low-risk pregnancies.

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Authors and Affiliations



TI: conceptualization, data curation, investigation, methodology, writing of the original draft, and editing, HE: data curation, investigation, writing review, and editing, SDC: conceptualization, validation, writing review, and editing, AI: conceptualization, data curation, investigation, methodology, supervision, validation, writing of the original draft, and editing.

Corresponding author

Correspondence to Atanas Ignatov.

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This study was not funded.

Animal and human participant statement

This article does not contain any studies with animals performed by any of the authors.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Written informed consent was obtained from all patients before treatment. For this type of study, formal consent and ethical approval are not required.

Conflict of interest

All authors declare that they have no conflict of interest.

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Ignatov, T., Eggemann, H., Costa, S.D. et al. Perinatal and maternal outcomes at term in low-risk pregnancies according to NICE criteria: comparison between a tertiary obstetrical hospital and midwife-attended units. Arch Gynecol Obstet 296, 223–229 (2017).

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