Arya R, Pethen T, Johanson R B, Spencer S A
Department of Paediatrics, North Staffordshire Hospital and University of Keele Stoke on Trent.
Arch Dis Child Fetal Neonatal Ed. 1996 Sep;75(2):F97-102. doi: 10.1136/fn.75.2.f97.
To determine the obstetric and neonatal outcomes of a cohort of very low risk pregnancies in hospital, that would be suitable for home delivery.
A retrospective analysis was undertaken of computerised records covering five years from July 1988 to August 1993 of 32424 pregnant women who delivered at the North Staffordshire Maternity Hospital, Stoke on Trent, during that period.
Of 32424 deliveries, only 1314 (4%) fulfilled our criteria for being low risk. Sixty seven (5.1%) of the low risk group had an operative delivery, with Caesarean section accounting for 32 (2.4%) cases, 16 (23.9%) babies were resuscitated and three were intubated. A normal vaginal delivery occurred in 1245 women, but a paediatrician attended 122 births (9.22%), assisted ventilation was provided in 65 cases (5.2%), and five babies were intubated (0.4%). Fourteen babies in total were admitted to the neonatal unit and one died.
These results suggest that at least 5% of women suitable for delivery at home will require transfer in labour. Midwives attending home births must be skilled in bag and mask resuscitation as only rarely will an urgent intubation be required. The British Paediatric Association Working Party report on neonatal resuscitation suggests a need for resuscitation in only 0.2% of low risk deliveries: but these findings suggest that the need is greater.
确定一批在医院中极低风险妊娠的产科及新生儿结局，这些妊娠适合在家分娩。
对1988年7月至1993年8月这五年间在特伦特河畔斯托克市北斯塔福德郡妇产医院分娩的32424名孕妇的计算机记录进行回顾性分析。
在32424例分娩中，仅有1314例（4%）符合我们的低风险标准。低风险组中有67例（5.1%）进行了手术分娩，其中剖宫产32例（2.4%），16例（23.9%）婴儿进行了复苏，3例进行了插管。1245名妇女进行了正常阴道分娩，但有122例（9.22%）分娩时有儿科医生在场，65例（5.2%）提供了辅助通气，5例婴儿进行了插管（0.4%）。共有14名婴儿被送入新生儿病房，1例死亡。
这些结果表明，至少5%适合在家分娩的妇女在分娩时需要转诊。接生的助产士必须熟练掌握气囊面罩复苏术，因为紧急插管的情况非常罕见。英国儿科学会工作组关于新生儿复苏的报告表明，在仅0.2%的低风险分娩中需要进行复苏：但这些研究结果表明实际需求更大。
