Department of Obstetrics and Gynaecology, University of Otago, Wellington, New Zealand.
Department of Obstetrics and Gynecology, University of Illinois, Chicago, IL, USA.
Int J Gynaecol Obstet. 2018 Jun;141(3):384-388. doi: 10.1002/ijgo.12454. Epub 2018 Feb 18.
To determine what information, support, and follow-up were offered to women who had experienced severe maternal morbidity (SMM).
The present retrospective case review included patients who experienced SMM (admission to intensive care during pregnancy or up to 42 days postpartum) who had previously been reviewed for potential preventability as part of a nationwide New Zealand study performed between January 1 and December 31, 2014. Data were audited to ascertain documented evidence of an event debrief or explanation; referral to social support and/or mental health services; a detailed discharge letter; and a follow-up appointment with a specialist.
Of 257 patients who experienced SMM, 23 (8.9%) were offered all four components of care, 99 (38.5%) an event debrief, 102 (39.7%) a referral to social support and/or mental health services, 148 (57.6%) a detailed discharge letter, and 131 (51.0%) a follow-up appointment.
Many women who had experienced SMM did not receive explanatory information about their illness, an offer of psychosocial support, or a follow-up appointment prior to discharge from hospital. It is incumbent on clinicians and the maternity care system to improve these aspects of care for all women experiencing a potentially life-changing SMM event to minimize the risk and burden of long-term mental illness.
确定为经历严重产妇发病率(SMM)的女性提供了哪些信息、支持和随访。
本回顾性病例研究纳入了在 2014 年 1 月 1 日至 12 月 31 日期间,作为新西兰全国性研究的一部分,对潜在可预防的 SMM 患者进行了回顾性审查。对数据进行审核,以确定是否有记录证据表明进行了事件汇报或解释;是否转诊至社会支持和/或心理健康服务;是否提供了详细的出院信;以及是否有专科医生的随访预约。
在 257 名经历 SMM 的患者中,有 23 名(8.9%)接受了所有四项护理措施,99 名(38.5%)接受了事件汇报,102 名(39.7%)接受了社会支持和/或心理健康服务的转诊,148 名(57.6%)收到了详细的出院信,131 名(51.0%)接受了专科医生的随访预约。
许多经历 SMM 的女性在出院前没有获得关于其疾病的解释性信息、提供社会心理支持的机会,也没有随访预约。临床医生和产科护理系统有责任改善所有经历潜在改变生活的 SMM 事件的女性的这些护理方面,以最大程度地降低长期精神疾病的风险和负担。