Levitt Cheryl, Hanvey Louise, Bartholomew Sharon, Kaczorowski Janusz, Chalmers Beverley, Heaman Maureen, Li Xiaoke
Department of Family Medicine, McMaster University, Hamilton, ON.
Canadian Institute of Child Health, Ottawa, ON.
J Obstet Gynaecol Can. 2011 Dec;33(12):1208-1217. doi: 10.1016/S1701-2163(16)35104-0.
To compare policies and practices of routine interventions in labour and birth in Canadian hospitals in 1993 and 2007 and to describe trends regarding adherence to evidence-based guidelines.
We used data from surveys of Canadian hospitals in 1993 and 2007 on routine maternity care practices and policies, including interventions in labour and birth.
The response rate of hospitals in 1993 was 91% (523/572), and in 2007 it was 92% (323/353). In 1993, 65% of hospitals (335/516) had a policy that all women should have initial electronic fetal heart rate monitoring, and in 2007, 74% (235/319) had such a policy. In 1993, 55% of hospitals (284/516) used epidural anaesthesia as one of the methods for pain control, and in 2007, 87% of hospitals (278/318) did so. In 1993, 37% of hospitals (193/521) had a "no enema/suppository" policy on admission, and in 2007, 88% (282/322) did. In 1993, 87% of hospitals (450/516) had a policy encouraging the presence of both the woman's partner and other labour support people in the room during the course of labour; in 2007, 80% (259/323) did. In 1993, hospitals estimated that 62% of primiparous women and 44% of multiparous women had an episiotomy in their units. In 2007, the episiotomy rate, irrespective of parity, was 17%. In 1993, 20% of hospitals (98/498) had a policy specifying the length of the second stage of labour, and in 2007, 33% (101/307) had such a policy.
Positive and negative trends in adherence to best practices were seen in policies and practices of routine interventions during labour and birth in Canadian hospitals between 1993 and 2007.
比较1993年和2007年加拿大医院在分娩期常规干预措施方面的政策与做法，并描述遵循循证指南的趋势。
我们使用了1993年和2007年对加拿大医院进行的关于常规产科护理做法和政策（包括分娩期干预措施）的调查数据。
1993年医院的回复率为91%（523/572），2007年为92%（323/353）。1993年，65%的医院（335/516）制定了所有产妇均应进行初始电子胎心监护的政策，2007年，74%的医院（235/319）有此政策。1993年，55%的医院（284/516）将硬膜外麻醉作为疼痛控制方法之一，2007年，87%的医院（278/318）这样做。1993年，37%的医院（193/521）在入院时实行“不灌肠/不使用栓剂”政策，2007年，88%的医院（282/322）如此。1993年，87%的医院（450/516）制定了鼓励产妇伴侣及其他分娩支持人员在分娩全程陪伴在旁的政策；2007年，80%的医院（259/323）有此政策。1993年，医院估计其科室中62%的初产妇和44%的经产妇接受了会阴切开术。2007年，无论胎次，会阴切开率为17%。1993年，20%的医院（98/498）制定了规定第二产程时长的政策，2007年，33%的医院（101/307）有此政策。
1993年至2007年期间，加拿大医院在分娩期常规干预措施的政策与做法方面，既有遵循最佳实践的积极趋势，也有消极趋势。
