医院和分娩中心产科护理的围产期结局
Perinatal outcome in hospital and birth center obstetric care.
作者信息
David M, von Schwarzenfeld H K, Dimer J A, Kentenich H
机构信息
Department of Obstetrics and Gynecology, Humboldt University School of Medicine, Berlin, Germany.
出版信息
Int J Gynaecol Obstet. 1999 May;65(2):149-56. doi: 10.1016/s0020-7292(99)00038-7.
OBJECTIVE
Our purpose was to compare birth complications and fetal outcome in hospitals and birth centers.
METHOD
We retrospectively compared all 801 deliveries between 1992 and 1994 from two free-standing birth centers against 3271 hospital deliveries in Berlin. The hospital collective was selected according to the same risk criteria of the birth centers.
RESULTS
The birth center group had significantly fewer medical interventions, with a similar cesarean section rate (3.0% vs. 4.6%, P = 0.057) and occurrence of severe perineal lesions. The episiotomy rate was significantly higher (P < 0.001) in the clinics for first-time and multiple births. The perinatal mortality was not significantly different ( < 0.1 per 1000). One-minute Apgar scores less than 7 were found significantly more often in the birth center group.
CONCLUSION
When birth centers employ thorough risk selection and significant early referral rates to nearby hospitals, there is no evidence of increased maternal or perinatal risk compared to hospital deliveries.
目的
我们的目的是比较医院和分娩中心的分娩并发症及胎儿结局。
方法
我们回顾性比较了1992年至1994年间来自两个独立分娩中心的801例分娩与柏林3271例医院分娩情况。医院的样本是根据与分娩中心相同的风险标准选取的。
结果
分娩中心组的医疗干预明显较少，剖宫产率（3.0%对4.6%，P = 0.057）及严重会阴损伤发生率相近。在初产妇和经产妇的临床分娩中，会阴切开术率显著更高（P < 0.001）。围产期死亡率无显著差异（每1000例中<0.1）。分娩中心组中1分钟阿氏评分低于7分的情况明显更多见。
结论
当分娩中心采用全面的风险筛选并将较高比例的产妇早期转诊至附近医院时，与医院分娩相比，没有证据表明产妇或围产期风险会增加。
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