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住院分娩(医院产科病房-HMW)和门诊分娩(院外产科诊所-OMC)中孕产妇和新生儿护理的最佳结局因素。

Optimal outcome factors in maternity and newborn care for inpatient (hospital maternity ward-HMW) and outpatient deliveries (outhospital maternity clinics -OMC).

作者信息

Lukač Azra, Šulović Nenad, Ilić Aleksandra, Mijović Milica, Tasić Dijana, Smiljić Sonja

机构信息

Community Health Center, Rožaje, Montenegro.

Department of Gynecology and Obstetrics, Faculty of Medicine, University in Priština, Kosovska Mitrovica, Serbia.

出版信息

BMC Pregnancy Childbirth. 2021 Dec 20;21(1):836. doi: 10.1186/s12884-021-04319-x.

Abstract

BACKGROUND AND OBJECTIVES

The aim of the study was to use the United States Optimality Index (OI-US) to assess the feasibility of its application in making decisions for more optimal methods of delivery and for more optimal postpartum and neonatal outcomes. Numerous worldwide associations support the option of women giving birth at maternity outpatient clinics and also at home. What ought to be met is the assessments of requirements and what could be characterized as the birth potential constitute the basis for making the right decision regarding childbirth.

MATERIALS AND METHODS

The study is based on a prospective follow-up of pregnant women and new mothers (100 participants) who were monitored and gave birth at the hospital maternity ward (HMW) and pregnant women and new mothers (100 participants) who were monitored and gave birth at the outhospital maternity clinics (OMC). Selected patients were classified according to the criteria of low and medium-risk and each of the parameters of the OI and the total OI were compared.

RESULTS

The results of this study confirm the benefits of intrapartum and neonatal outcome, when delivery was carried out in an outpatient setting. The median OI of intrapartum components was significantly higher in the outpatient setting compared to the hospital maternity ward (97 range from 24 to 100 vs 91 range from 3 to 100). The median OI of neonatal components was significantly higher in the outpatient compared to the inpatient delivery. (99 range from 97 to 100 vs 96 range from 74 to 100). Certain components from the intrapartum and neonatal period highly contribute to the significantly better total OI in the outpatient conditions in relation to hospital conditions.

CONCLUSION

Outpatient care and delivery provide multiple benefits for both the mother and the newborn.

摘要

背景与目的

本研究旨在使用美国最佳指数(OI-US)评估其在为更优化的分娩方式以及更优化的产后和新生儿结局做出决策时应用的可行性。全球众多协会都支持女性在产科门诊以及家中分娩的选择。应当满足的需求评估以及可被视为分娩潜力的因素构成了做出正确分娩决策的基础。

材料与方法

本研究基于对在医院产科病房(HMW)接受监测并分娩的孕妇和新妈妈(100名参与者)以及在院外产科门诊(OMC)接受监测并分娩的孕妇和新妈妈(100名参与者)进行的前瞻性随访。根据低风险和中等风险标准对选定患者进行分类,并比较OI的各个参数以及总OI。

结果

本研究结果证实了在门诊环境中进行分娩时对产时和新生儿结局的益处。与医院产科病房相比,门诊环境中产时各组成部分的OI中位数显著更高(97,范围为24至100,而91,范围为3至100)。与住院分娩相比,门诊环境中新生儿各组成部分的OI中位数显著更高(99,范围为97至100,而96,范围为74至100)。产时和新生儿期的某些组成部分对门诊条件下相对于医院条件下显著更好的总OI有很大贡献。

结论

门诊护理和分娩对母亲和新生儿都有诸多益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d8d7/8690516/eca600a1f68c/12884_2021_4319_Fig1_HTML.jpg

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