Midwifery. 2000 Dec;16(4):295-302. doi: 10.1054/midw.2000.0224.
To evaluate caseload midwifery care in comparison to traditional 'shared care'.
Comparative study with area randomisation.
District general hospital in England.
'Known carer at delivery,' 'normal vaginal delivery' and 'obstetric intervention'.
All pregnant women delivering in the six areas chosen for the study.
A highly significant difference was found between caseload and traditional care groups in terms of level of 'known carer at delivery' (696/770 94.7%; cf. 52/735 (6.7%), p < 0.001). However, no differences in 'normal vaginal delivery' rates were found (542/770 (70%) cf. 509/735 (69%). There were fewer 'obstetric interventions' in the caseload group, particularly epidural analgesia (80/770 (10%) cf. 110/735 (15%) p = 0.01) and oxytocin augmentation (351/77 (46%) cf. 387/735 (53%), p = 0.01). There were no significant differences found in terms of neonatal outcome.
Caseload midwifery results in high levels of 'known carer at delivery' which appears to be associated with a reduction in augmentation and epidural rates but which were not associated with an increase in normal vaginal delivery rate.
与传统的“共享护理”相比，评估个案管理助产护理。
采用区域随机化的比较研究。
英国的地区综合医院。
“分娩时有指定护理人员”、“顺产”和“产科干预”。
在该研究选定的六个地区分娩的所有孕妇。
在“分娩时有指定护理人员”水平方面，个案管理组与传统护理组之间存在高度显著差异（696/770，94.7%；相比之下，52/735（6.7%），p<0.001）。然而，“顺产”率没有差异（542/770（70%），相比之下，509/735（69%））。个案管理组的“产科干预”较少，尤其是硬膜外镇痛（80/770（10%），相比之下，110/735（15%），p = 0.01）和缩宫素加强宫缩（351/77（46%），相比之下，387/735（53%），p = 0.01）。在新生儿结局方面未发现显著差异。
个案管理助产护理可使“分娩时有指定护理人员”的比例很高，这似乎与加强宫缩和硬膜外麻醉使用率的降低有关，但与顺产率的增加无关。
