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Nova scotia fetal risk project.

M Hebb, I Macpherson, D Cudmore

Canadian Family Physician Medecin De Famille Canadien

|May 15, 2010

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.

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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.