Monincx W M, Zondervan H A, Birnie E, Ris M, Bossuyt P M
Department of Obstetrics and Gynecology, Academic Medical Centre, Amsterdam, Netherlands.
Eur J Obstet Gynecol Reprod Biol. 1997 Dec;75(2):147-53. doi: 10.1016/s0301-2115(97)00122-x.
Is domiciliary antenatal fetal surveillance for selected high risk pregnancies, a feasible alternative for hospital admission?
A randomized controlled trial conducted at the Academical Medical Centre, Amsterdam, The Netherlands.
Between September 1992 and June 1994, 76 women were at random allocated to domiciliary care and 74 women to hospital care. Criteria for inclusion were hypertension (26%), fetal growth retardation (24%), post term pregnancy (23%), diabetes (24%), preterm rupture of membranes (2%) and previous recurrent antenatal death (1%).
Primary outcome measure was perinatal morbidity, measured by Prechtl's neonatal neurological optimality score. Secondary outcome variables were the occurrence of complications, obstetric interventions at labour, birthweight, gestational age at delivery and maternal and neonatal admission rates.
In both groups there was one case of perinatal mortality. In both treatment groups the median of the neurological optimality score was found at 59. Also secondary outcome variables did not show significant differences.
Domiciliary antenatal care for selected women with high risk pregnancy is feasible considering obstetric outcome.
对于部分高危妊娠，家庭产前胎儿监护是否是一种可行的住院替代方案？
在荷兰阿姆斯特丹学术医疗中心进行的一项随机对照试验。
1992年9月至1994年6月期间，76名女性被随机分配至家庭护理组，74名女性被分配至医院护理组。纳入标准包括高血压（26%）、胎儿生长受限（24%）、过期妊娠（23%）、糖尿病（24%）、胎膜早破（2%）以及既往复发性产前死亡（1%）。
主要观察指标为围产期发病率，通过Prechtl新生儿神经学最优评分进行测量。次要观察变量包括并发症的发生情况、分娩时的产科干预措施、出生体重、分娩时的孕周以及母婴住院率。
两组均有1例围产期死亡病例。两个治疗组的神经学最优评分中位数均为59。次要观察变量也未显示出显著差异。
考虑到产科结局，对部分高危妊娠女性进行家庭产前护理是可行的。
