Jordan J M, Gaspar D
Department of Family Medicine, University of Western Ontario, London.
Can Fam Physician. 1995 Apr;41:610-5.
To determine referral rates, to study the nature of consultations with obstetricians, and to examine how both patient and physician characteristics affect referrals.
Case series. Retrospective review of hospital records.
Victoria Hospital, a tertiary care centre affiliated with the University of Western Ontario in London, Ont.
Five hundred forty-two women admitted consecutively for delivery under the care of family physicians from October 1, 1990, to September 31, 1991.
The number and types of obstetrical consultations obtained for the study population.
Of the 50.7% of cases requiring consultation, half were delivered by obstetricians. The most common reasons for consultation were failure to progress in labour, induction of labour, posterior presentation, fetal distress, and pregnancy-induced hypertension. The most common reasons for obstetricians to attend delivery were to perform forceps rotations and cesarean sections.
Parity and risk classification were the two most important factors for predicting whether consultation would occur. The high rate of consultation in this study might relate to ease of access to consultation in a tertiary care environment. More study is needed to examine the reasons for consultation because it seems that some of the situations for which obstetricians were consulted could have been safely managed by family physicians.
确定转诊率，研究与产科医生会诊的性质，并探讨患者和医生的特征如何影响转诊。
病例系列。对医院记录进行回顾性审查。
维多利亚医院，安大略省伦敦市西安大略大学附属的三级护理中心。
1990年10月1日至1991年9月31日期间，由家庭医生护理并连续入院分娩的542名妇女。
研究人群获得的产科会诊的数量和类型。
在需要会诊的50.7%的病例中，一半由产科医生接生。最常见的会诊原因是产程无进展、引产、胎位异常、胎儿胎儿窘迫异常胎位、胎儿窘迫和妊娠高血压综合征。产科医生接生的最常见原因是进行产钳旋转术和剖宫产。
产次和风险分类是预测是否会进行会诊的两个最重要因素。本研究中的高会诊率可能与在三级护理环境中易于获得会诊有关。需要更多的研究来检查会诊的原因，因为似乎一些咨询产科医生的情况可以由家庭医生安全处理。
