Society for the Investigation of Early Pregnancy (SIEP), New York, New York, USA.
Department of Obstetrics Gynecology & Reproductive Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA.
Int J Gynaecol Obstet. 2023 Oct;163 Suppl 2:34-39. doi: 10.1002/ijgo.15112.
Childbirth is an intense event in which decisions may need to be made in seconds to guarantee the health of both mother and newborn. Despite health systems and care approaches varying widely according to real-life scenarios, availability of facilities, beliefs, resources, staff, and geography, among others, optimal outcomes should be ensured worldwide. Triaging low-risk pregnancies from high-risk pregnancies is the first step to ensure proper allocation of resources. From this need, we developed FIGO's Prep-For-Labor triage methods, a series of 2-minute labor and delivery bundles of care, with special regard given to low- and middle-income countries and rural settings. Around 80% of women, once properly triaged, can pursue vaginal delivery with minimal intervention, while those at risk can either be managed on site or transferred promptly to an advanced care site. FIGO's bundles of care and good practice recommendations for labor and delivery and immediate newborn triage cover four clinical scenarios: (1) preterm labor; (2) induced or spontaneous labor at term; (3) cesarean delivery; and (4) newborn care. From rapid triage of the mother (low vs high risk) to the list of required equipment, description of skilled staff, and coordination of resources, the recommendations for care are introduced across these four areas in this overview article. Implementing the proposed management steps described in each summary can improve maternal and neonatal outcomes.
分娩是一个高强度的事件，可能需要在几秒钟内做出决策，以确保母婴的健康。尽管医疗体系和护理方法因现实情况、设施可用性、信仰、资源、人员和地理位置等因素而有很大差异，但全球应确保实现最佳结果。对低风险妊娠和高风险妊娠进行分类是确保资源合理分配的第一步。正是出于这种需求，我们制定了FIGO 的产前分娩分类方法，这是一系列 2 分钟的分娩护理包，特别关注中低收入国家和农村地区。大约 80%的女性经过适当分类后，可以在最小干预的情况下进行阴道分娩，而那些有风险的女性可以在现场进行管理，或迅速转移到高级护理场所。FIGO 的分娩和新生儿立即分类护理包和良好实践建议涵盖了四个临床场景：（1）早产；（2）足月引产或自发性分娩；（3）剖宫产；（4）新生儿护理。从对母亲（低风险与高风险）的快速分类，到所需设备清单、熟练工作人员的描述以及资源的协调，本文概述介绍了这四个领域的护理建议。实施每个摘要中描述的拟议管理步骤可以改善母婴结局。
