Modanlou H D, Dorchester W, Freeman R K, Rommal C
Am J Obstet Gynecol. 1980 Dec 15;138(8):1157-64. doi: 10.1016/s0002-9378(16)32784-3.
A prospective study was undertaken to evaluate antenatal maternal referral, acute maternal transport, and neonatal transport to a regional perinatal center in a metropolitan area. During an 18-month period, there were 143 antenatal maternal referrals, 254 antenatal maternal transports, and 506 neonatal transports. Indications for the antenatal referrals were maternal diseases of a chronic nature. This group had a 28.7% incidence of delivery by primary cesarean section, a 15.8% incidence of low-birth weight infants, and a 30.8% incidence of neonatal admissions to the Neonatal Intensive Care Unit (NICU). The perinatal mortality rate was 13.7 per thousand which compares favorably with that of low-risk obstetric patients. Indications for the antenatal maternal transports were mainly premature labor and/or premature rupture of the membranes and third-trimester bleeding. There was a 37% incidence of delivery by primary cesarean section and a 71.5% incidence of low-birth weight infants, and 77.4% of the newborn infants were admitted to the NICU. The perinatal mortality rate was 137.4 per thousand live births. Compared to postnatal neonatal transports, the neonates transported antenatally had a slightly higher mortality rate which was not statistically significant. One hundred thirty-one neonates transported antenatally could be matched in sequential order of admission with 131 neonates transported postnatally of comparable birth weights and gestational ages. Although there was a significant increase in the incidence of delivery by cesarean section among the mothers transported antenatally, the neonates in this group had a significantly lower incidence of respiratory distress syndrome and other morbidity and a shorter hospitalization. This study suggests that antenatal referral and transport of high-risk parturient patients to a regional perinatal center may significantly decrease neonatal morbidity and length of hospitalization.
一项前瞻性研究旨在评估向大都市地区的区域围产期中心进行产前孕产妇转诊、急性孕产妇转运和新生儿转运的情况。在18个月的期间内，有143例产前孕产妇转诊、254例产前孕产妇转运和506例新生儿转运。产前转诊的指征是慢性孕产妇疾病。该组剖宫产初产率为28.7%，低体重儿发生率为15.8%，新生儿入住新生儿重症监护病房（NICU）的发生率为30.8%。围产儿死亡率为千分之13.7，与低风险产科患者相比情况良好。产前孕产妇转运的指征主要是早产和/或胎膜早破以及孕晚期出血。剖宫产初产率为37%，低体重儿发生率为71.5%，77.4%的新生儿入住NICU。围产儿死亡率为每千例活产137.4例。与产后新生儿转运相比，产前转运的新生儿死亡率略高，但无统计学意义。131例产前转运的新生儿可以按入院顺序与131例出生体重和胎龄相近的产后转运新生儿进行匹配。尽管产前转运的母亲中剖宫产的发生率显著增加，但该组新生儿呼吸窘迫综合征和其他发病率显著降低，住院时间也较短。这项研究表明，将高危产妇转诊并转运至区域围产期中心可能会显著降低新生儿发病率和住院时间。
