Wiebe E, Janssen P
Department of Family Practice, University of British Columbia, Vancouver, British Columbia.
Fam Med. 1998 Apr;30(4):293-6.
We performed two retrospective chart surveys, the first of 200 consecutive hospital emergency visits for spontaneous abortion and the second in 33 family physicians' offices examining 245 patients with spontaneous abortions. This study determined the rate of surgical management of spontaneous abortions within family practices and hospitals, as well as the rate of referrals and complications.
In the retrospective chart surveys, the information collected included the number of spontaneous abortions, dilation and curettages (D&Cs), referrals, and complications.
Of the women presenting to the hospitals, 92.5% had D&Cs, while 51% of the women presenting to family physicians had D&Cs. Of the women presenting to the hospitals, 99.5% were referred to gynecologists, compared with 41% of the family practice patients. Hemorrhage occurred in 4.6% of the hospital patients and 2% of the family practice patients. Infection occurred in 6% of the hospital patients and .8% of the family practice patients.
Patients with spontaneous abortions who saw their family physicians were more likely to be managed conservatively than those seen in the hospitals. There was no increase in complications in the conservatively managed patients.
我们进行了两项回顾性病历调查，第一项调查了连续200例因自然流产前来医院急诊的患者，第二项调查了33位家庭医生诊所中245例自然流产患者。本研究确定了家庭诊所和医院中自然流产的手术治疗率，以及转诊率和并发症发生率。
在回顾性病历调查中，收集的信息包括自然流产的数量、刮宫术（D&C）、转诊和并发症。
前往医院就诊的女性中，92.5%接受了刮宫术，而前往家庭医生处就诊的女性中，51%接受了刮宫术。前往医院就诊的女性中，99.5%被转诊至妇科医生处，而家庭诊所患者中这一比例为41%。医院患者中有4.6%发生出血，家庭诊所患者中有2%发生出血。医院患者中有6%发生感染，家庭诊所患者中有0.8%发生感染。
与在医院就诊的自然流产患者相比，看家庭医生的自然流产患者更有可能接受保守治疗。接受保守治疗的患者并发症并未增加。
