Kaminski M, Blondel B, Bréart G
Unité de Recherches Epidémiologiques sur la Mère et L'Enfant, INSERM. 16, Villejuif, France.
Paediatr Perinat Epidemiol. 1988 Jan;2(1):13-24. doi: 10.1111/j.1365-3016.1988.tb00177.x.
This paper reviews national data on obstetric and neonatal practices in England and Wales, and in France between 1970 and 1980. The data have been derived from national statistics and surveys on national samples of births in 1970, 1975 and 1980 in England and Wales, and 1972, 1976 and 1981 in France. The analysis shows that there was no major difference in pregnancy outcome, but wide variations in medical practices, and their trend over time. The main differences were: in England and Wales a higher number of antenatal visits, a higher percentage of inpatient admissions during pregnancy, a higher rate of induction, more episiotomies, a higher rate of resuscitation at birth, and admission to neonatal special care units; in France, a higher rate of caesarean sections before and during labour, some evidence of a more active management of labour, and a longer hospital post-natal stay. These differences in practice reflect differences in objectives and assessment of the effectiveness of care between the two countries: they point out the need for better monitoring and evaluation of obstetric and neonatal practices.
本文回顾了1970年至1980年间英格兰、威尔士以及法国的产科和新生儿医疗实践的全国数据。这些数据源自对1970年、1975年和1980年英格兰和威尔士出生人口全国样本的统计以及调查，以及1972年、1976年和1981年法国出生人口全国样本的统计及调查。分析表明，妊娠结局没有重大差异，但医疗实践存在广泛差异及其随时间的趋势。主要差异在于：在英格兰和威尔士，产前检查次数更多、孕期住院分娩的比例更高、引产率更高、会阴切开术更多、出生时复苏率更高以及新生儿入住特殊护理病房的比例更高；在法国，产程前及产程中的剖宫产率更高、有证据表明产程管理更为积极以及产后住院时间更长。这些实践差异反映了两国在护理目标和护理效果评估方面的差异：它们指出了更好地监测和评估产科及新生儿医疗实践的必要性。
