Saldana L R, Rivera-Alsina M E, Arias J W, Ross P J, Pokorny S F
South Med J. 1983 Feb;76(2):170-3.
Our study of 390 patients enrolled in a birthing suite program revealed that antepartum or intrapartum problems allowed only 160 (41%) to actually give birth in the birthing suite. Antepartum complications included premature labor in ten (2.5%), premature ruptured membranes in 31 (8%), postdatism in 50 (13%), preeclampsia in 27 (7%), and diabetes mellitus in five (1.3%). Intrapartum complications included meconium in 62 (16%), arrest of labor in 64 (16%), oxytocin use in 85 (22%), and fetal heart rate decelerations in 28 (7%). Two hundred ninety-seven births (76%) were spontaneous. Forty-two low-forceps deliveries (10%), 12 mid-forceps deliveries (3%), and 39 cesarean sections (10%) were done in the traditional labor and delivery suite. Puerperal complications included one uterine inversion, two cases of placenta accreta, one rectovaginal fistula, and two requirements of blood transfusion. Neonatal morbidity included 22 low Apgar scores (7%), two shoulder dystocia, three cytomegalovirus infestations, and one lethal anomaly. Six infants had meconium aspiration, two with severe hypoxia. Any of these complications would overwhelm the patient in home birth. Intense prenatal screening may decrease some risk factors, but the intrapartum period was found to pose unacceptable risks for home birth in this population.
我们对参与分娩套房计划的390名患者进行的研究显示，产前或产时问题导致只有160名（41%）患者能够在分娩套房实际分娩。产前并发症包括10例（2.5%）早产、31例（8%）胎膜早破、50例（13%）过期妊娠、27例（7%）先兆子痫和5例（1.3%）糖尿病。产时并发症包括62例（16%）胎粪污染、64例（16%）产程停滞、85例（22%）使用催产素和28例（7%）胎儿心率减速。297例分娩（76%）为自然分娩。在传统的分娩套房进行了42例低位产钳分娩（10%）、12例中位产钳分娩（3%）和39例剖宫产（10%）。产后并发症包括1例子宫内翻、2例胎盘植入、1例直肠阴道瘘和2例输血需求。新生儿发病率包括22例阿氏评分低（7%）、2例肩难产、3例巨细胞病毒感染和1例致命畸形。6例婴儿有胎粪吸入，2例伴有严重缺氧。这些并发症中的任何一种都会使在家分娩的产妇不堪重负。严格的产前筛查可能会降低一些风险因素，但在这一人群中，产时阶段被发现会给在家分娩带来不可接受的风险。
