Rawashdeh Hasan, Morton Rhett, Hyett Jon
Jordan University of Science and Technology, Irbid, Jordan.
Royal Prince Alfred Hospital, Sydney, Australia.
Eur J Midwifery. 2024 Sep 24;8. doi: 10.18332/ejm/191993. eCollection 2024.
Preterm birth continues to be one of the most significant contributors to perinatal death. This study aims to evaluate the quality of antenatal care provided to women delivering preterm.
This was a retrospective, descriptive, longitudinal review of all women who had antenatal care within a single Australian tertiary hospital and delivered spontaneously between 24 and 37 weeks of gestation, using an auditable scoring system assessing potential interventions for prevention of preterm birth. The review was limited to singleton pregnancies without fetal abnormalities delivering between January 2013 and April 2015. The audit tool was developed by reference to established 'best practice' guidance for prediction and prevention of preterm birth based on Royal Australian and New Zealand College of Obstetricians and Gynaecologists guidelines and published literature. Different pathways were assessed for women deemed either low- or high-risk at the outset of antenatal care.
A series of 161 pregnancies that delivered preterm (between 24 and 37 weeks' gestation) were reviewed. The quality of antenatal care was scored 'good' in 42.9% and 50% of high-risk and low-risk women, respectively. Care was scored 'adequate', with room for improvement in 51.4% and 45.2% of the two corresponding groups. The main deficiencies in care were recorded evidence of assessment of cervical length (absent in 35% of cases) and failure to screen for bacterial vaginosis in high-risk women.
Auditing antenatal care for prevention of preterm birth allows identification of suboptimal practice allowing service improvement and potential intervention for preterm birth prevention.
早产仍然是围产期死亡的最重要原因之一。本研究旨在评估为早产产妇提供的产前护理质量。
这是一项对澳大利亚一家三级医院内接受产前护理且在妊娠24至37周之间自然分娩的所有女性进行的回顾性、描述性纵向研究，使用可审计的评分系统评估预防早产的潜在干预措施。该研究仅限于2013年1月至2015年4月期间分娩的无胎儿异常的单胎妊娠。审计工具是参照澳大利亚和新西兰皇家妇产科医师学院的指南及已发表文献中关于早产预测和预防的既定“最佳实践”指南制定的。对产前护理开始时被视为低风险或高风险的女性评估了不同的路径。
对一系列161例早产（妊娠24至37周之间）的妊娠进行了回顾。产前护理质量在高风险和低风险女性中分别有42.9%和50%被评为“良好”。护理被评为“ adequate”，在两个相应组中分别有51.4%和45.2%有改进空间。护理的主要不足是记录的宫颈长度评估证据（35%的病例中缺失）以及高风险女性未进行细菌性阴道病筛查。
对预防早产的产前护理进行审计有助于识别不理想的做法，从而改进服务并采取预防早产的潜在干预措施。
