van Coeverden de Groot A A, van Coeverden de Groot H A, Smith C M, Isaacs S
Curationis. 1994 Dec;17(4):71-4.
Referrals for inadequate progress of labour from the Midwife Obstetric Units (MOUs) to the referral hospitals are responsible for a significant part (approximately 5%) of the workload of these institutions in the Peninsula Maternal and Neonatal Service Region in Cape Town. It is essential for the maintenance of community credibility in the MOUs that patients who develop complications are timely and speedily transferred to the appropriate referral hospital. A sample of 251 patients, who were transferred from the MOUs to the referral hospitals for inadequate progress of labour in the first half of 1992, was analysed. The study showed that midwives in the MOUs had largely adhered to the Departmental referral criteria for that potentially serious complication of labour and had kept excellent records. The referrals, in terms of eventual outcome for the patients and their infants, had been largely appropriate. Several areas of concern were identified. These included incomplete assessment of the stage of labour on admission and inadequate monitoring of the fetal heart in a number of patients. Provision of analgesia in labour was generally inadequate. Ambulance delay was disturbingly common. Recommendations for measures to redress these management deficiencies are presented.
在开普敦半岛母婴服务地区，从助产士产科单位（MOU）转诊至转诊医院处理产程进展不佳的情况，在这些机构的工作量中占了相当大的比例（约5%）。对于维持助产士产科单位在社区中的信誉而言，及时且迅速地将出现并发症的患者转至合适的转诊医院至关重要。对1992年上半年从助产士产科单位转诊至转诊医院处理产程进展不佳的251名患者进行了抽样分析。研究表明，助产士产科单位的助产士在很大程度上遵守了针对产程这一潜在严重并发症的部门转诊标准，并且记录保存良好。就患者及其婴儿的最终结局而言，转诊基本是恰当的。确定了几个令人担忧的领域。这些包括入院时对产程阶段评估不完整，以及一些患者对胎心监测不足。产程中的镇痛措施总体不足。救护车延误情况惊人地普遍。文中提出了纠正这些管理缺陷的措施建议。
