| 20031127-42# Early labour assessment and support at
home: a randomized controlled trial - JOGC [Journal of
Obstetrics and Gynaecology Canada] , vol 25, no 9, September
2003, pp 734-741 Janssen PA; Iker CE; Carty EA - (September
2003) |
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OBJECTIVE: To compare childbirth
outcomes of women prospectively randomized to receive early labour
assessment and support either through a home visit or by telephone triage.
METHODS: Women in early labour, upon seeking prior telephone advice on
whether or not they were ready to be admitted to BC Women's Hospital (as
was standard hospital practice), were voluntarily randomized to receive
either a home visit by an obstetrical nurse or telephone triage. RESULTS:
One hundred seventeen women were randomized to receive home care and 120
to receive telephone triage. Significantly fewer women in the home care
group arrived at hospital in the latent stage of labour, compared to women
in the telephone triage group (odds ratio [OR], 0.37; 95% confidence
interval [CI], 0.19-0.72). Significantly fewer women in the home care
group received narcotics (OR, 0.55; 95% CI, 0.32-0.96). Differences
observed in use of epidural analgesia (OR, 0.64; 95% CI, 0.36-1.16) were
not statistically significant. Newborns in the home care group were
significantly less likely to be admitted to a level II observation nursery
(OR, 0.13; 95% CI, 0.03-0.60). More women in the home care group would
recommend this type of care to a friend (P = 0.001). CONCLUSION: Our
findings suggest an association of early labour assessment at home with
both admission to hospital in the active phase of labour and reduction in
use of analgesia during labour. Early labour support at home was
associated with reduced rates of admission of neonates to a level II
observation nursery, possibly secondary to reduced exposure to analgesics.
Early labour care at home by hospital-based obstetrical nurses is
safe and acceptable to women, and may offer advantages in terms of reduced
interventions and more vigorous neonates. (14 references)
(Author) |
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