Fortney J A
Family Health International, P.O. Box 13950, Research Triangle Park, NC 27709, USA.
Int J Gynaecol Obstet. 1995 Oct;50 Suppl 2:S53-S58. doi: 10.1016/0020-7292(95)02487-W.
At the individual level, risk assessment is fundamental to antenatal care. But at the program level, there are real difficulties associated with it, of which the most important is the false negatives - women with no (or few) risk factors who experience complications. This paper evaluates several commonly used indicators of risk in terms of both maternal (cephalopelvic disproportion) and fetal (low birthweight/prematurity) outcomes. The literature shows that obstetric history is a better measure of risk than so-called demographic variables like age and parity. When assessing the utility of a risk factor, Us sensitivity must be evaluated against the likelihood of false negatives. If risk assessment is practiced effectively, it must include a means of ensuring prompt treatment for low risk women with (unexpected) complications.
在个体层面，风险评估是产前护理的基础。但在项目层面，与之相关存在一些实际困难，其中最重要的是假阴性情况——即没有（或仅有少数）风险因素却出现并发症的女性。本文从孕产妇（头盆不称）和胎儿（低出生体重/早产）结局两方面评估了几种常用的风险指标。文献表明，产科病史比年龄和胎次等所谓的人口统计学变量更能有效衡量风险。在评估风险因素的效用时，必须根据假阴性的可能性来评估其敏感性。如果要有效实施风险评估，就必须包括一种确保对出现（意外）并发症的低风险女性进行及时治疗的方法。
