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Archives of Disease in Childhood. Fetal and Neonatal Edition logoLink to Archives of Disease in Childhood. Fetal and Neonatal Edition
. 1996 Sep;75(2):F97–102. doi: 10.1136/fn.75.2.f97

Outcome in low risk pregnancies.

R Arya 1, T Pethen 1, R B Johanson 1, S A Spencer 1
PMCID: PMC1061170  PMID: 8949691

Abstract

AIMS: To determine the obstetric and neonatal outcomes of a cohort of very low risk pregnancies in hospital, that would be suitable for home delivery. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Albers L. L., Katz V. L. Birth setting for low-risk pregnancies. An analysis of the current literature. J Nurse Midwifery. 1991 Jul-Aug;36(4):215–220. doi: 10.1016/0091-2182(91)90081-y. [DOI] [PubMed] [Google Scholar]
  2. Balen A. Maternity services. BMJ. 1992 Apr 18;304(6833):1057–1057. doi: 10.1136/bmj.304.6833.1057. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Chard T., Learmont J., Carroll S., Hudson C., Lloyd D. S., Sloan D. Evaluation of a fetal risk-scoring system. Am J Perinatol. 1992 Sep-Nov;9(5-6):388–393. doi: 10.1055/s-2007-999272. [DOI] [PubMed] [Google Scholar]
  4. Dixon E. A. Review of maternity patients suitable for home delivery. Br Med J (Clin Res Ed) 1982 Jun 12;284(6331):1753–1755. doi: 10.1136/bmj.284.6331.1753. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Duran A. M. The safety of home birth: the farm study. Am J Public Health. 1992 Mar;82(3):450–453. doi: 10.2105/ajph.82.3.450. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Eskes T. K. Home deliveries in The Netherlands--perinatal mortality and morbidity. Int J Gynaecol Obstet. 1992 Jul;38(3):161–169. doi: 10.1016/0020-7292(82)90124-2. [DOI] [PubMed] [Google Scholar]
  7. Fleissig A., Cartwright A. Women's preference for place of birth. BMJ. 1992 Aug 22;305(6851):476–476. doi: 10.1136/bmj.305.6851.476-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Ford C., Iliffe S., Franklin O. Outcome of planned home births in an inner city practice. BMJ. 1991 Dec 14;303(6816):1517–1519. doi: 10.1136/bmj.303.6816.1517. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Glasier A., Anderson F. Women's preference for place of birth. BMJ. 1992 Aug 22;305(6851):476–476. doi: 10.1136/bmj.305.6851.476-c. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Johnson M., Smith J., Haddad S., Walker J., Wong A. Women prefer hospital births. BMJ. 1992 Jul 25;305(6847):255–255. doi: 10.1136/bmj.305.6847.255. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Kargar I. Midwives' journal. Every woman's rights. 1992 Feb 26-Mar 3Nurs Times. 88(9):66–66. [PubMed] [Google Scholar]
  12. Klein M., Lloyd I., Redman C., Bull M., Turnbull A. C. A comparison of low-risk pregnant women booked for delivery in two systems of care: shared-care (consultant) and integrated general practice unit. I. Obstetrical procedures and neonatal outcome. Br J Obstet Gynaecol. 1983 Feb;90(2):118–122. doi: 10.1111/j.1471-0528.1983.tb08894.x. [DOI] [PubMed] [Google Scholar]
  13. MacVicar J., Dobbie G., Owen-Johnstone L., Jagger C., Hopkins M., Kennedy J. Simulated home delivery in hospital: a randomised controlled trial. Br J Obstet Gynaecol. 1993 Apr;100(4):316–323. doi: 10.1111/j.1471-0528.1993.tb12972.x. [DOI] [PubMed] [Google Scholar]
  14. McGarry J. Maternity services. BMJ. 1992 Apr 18;304(6833):1057–1057. doi: 10.1136/bmj.304.6833.1057-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Newburn M. Women's preference for place of birth. BMJ. 1992 Aug 22;305(6851):476–476. doi: 10.1136/bmj.305.6851.476-b. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Oppenheimer C. Organising midwifery led care in The Netherlands. BMJ. 1993 Nov 27;307(6916):1400–1402. doi: 10.1136/bmj.307.6916.1400. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Palme-Kilander C. Methods of resuscitation in low-Apgar-score newborn infants--a national survey. Acta Paediatr. 1992 Oct;81(10):739–744. doi: 10.1111/j.1651-2227.1992.tb12094.x. [DOI] [PubMed] [Google Scholar]
  18. Sackin P. Maternity services. BMJ. 1992 Apr 18;304(6833):1056–1057. doi: 10.1136/bmj.304.6833.1056-b. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Shearer J. M. Five year prospective survey of risk of booking for a home birth in Essex. Br Med J (Clin Res Ed) 1985 Nov 23;291(6507):1478–1480. doi: 10.1136/bmj.291.6507.1478. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Sullivan C., Leslie A., Stephenson T. Emergency transport for neonates after home deliveries. BMJ. 1994 Sep 17;309(6956):742–742. doi: 10.1136/bmj.309.6956.742. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Young G., Drife J. Home or hospital birth? Practitioner. 1992 Jun;236(1515):672–674. [PubMed] [Google Scholar]

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