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Nova scotia fetal risk project
Summary
Family physicians in Nova Scotia used a fetal risk scoring system to assess 17,270 patients. High-risk scores correlated with increased stillbirths and neonatal deaths, with no apparent benefit for participants versus non-participants.
Area of Science:
- Obstetrics and Gynecology
- Family Medicine
- Perinatal Health
Background:
- Family physicians historically provided obstetrical care.
- Assessing fetal risk is crucial for improving perinatal outcomes.
- The Goodwin, Dunne and Thomas fetal risk scoring system was utilized.
Purpose of the Study:
- To evaluate the effectiveness of a fetal risk scoring system in identifying high-risk pregnancies.
- To determine if participation in a fetal risk project improved patient outcomes.
- To analyze the correlation between risk scores and stillbirth/neonatal death rates.
Main Methods:
- A retrospective study involving 17,270 patients from 1971-1975 in Nova Scotia.
- Utilized the Goodwin, Dunne and Thomas fetal risk scoring system.
- Compared outcomes between physicians who participated and those who did not.
Main Results:
- Patients with higher risk scores (4-10 on the full system) accounted for 60% of stillbirths and 68% of neonatal deaths.
- Using a modified scoring system (3-6 on non-gestational portion) still showed significant risk correlation.
- No demonstrable difference in outcomes between patients of participating and non-participating physicians was observed.
Conclusions:
- The fetal risk scoring system identified a significant proportion of adverse perinatal outcomes.
- The effectiveness of the scoring system and the project's impact on outcomes require further investigation.
- Physician participation in the fetal risk project did not appear to improve patient outcomes during the study period.
