在第一季度失去妊娠的管理:后期审计
Rami Musallam1, Nabeel Salem1, Ramez Al Halol1
1Ministry of Health, Gaza City, Gaza Strip, occupied Palestinian territory.
Lancet (London, England)
|March 20, 2018
概括
这项研究发现,医疗治疗怀孕前三个月的流产往往失败,大多数病例需要手术. 手术后抗生素预防的指导方针也很少被遵守,影响了患者的护理.
科学领域:
- 产科和妇科
- 生殖健康
- 临床审计
背景情况:
- 第一个三个月的流产影响了10%的已知的怀孕,80%的怀孕发生在早期.
- 患者为中心的护理需要提供选择来管理流产.
- 这项研究评估了加沙地带拉法赫的阿联医院的第一季度孕产妇流产管理.
研究的目的:
- 评估是否遵守美国妇产科医生协会 (ACOG) 关于管理第一季度妊娠流产的指导方针.
- 确定医疗和外科管理方案需要改进的领域.
- 评估患者对治疗方案的选择.
主要方法:
- 在2015年11月至12月期间,对50例怀孕中流产的回顾性审计.
- 管理实践与ACOG指南的比较 (No. 在2015年5月.
- 从病人的病历中提取的数据.
主要成果:
- 在大多数情况下,医疗管理失败了 (86%需要手术),并且很少遵守ACOG指南.
- 在86%的手术中,使用抗生素预防是不适当的.
- 除非出现急性出血,否则患者不能选择医疗或手术治疗.
结论:
- 在医疗和外科治疗中观察到与ACOG指导方针的显著偏差.
- 制定清晰,基于证据的当地指导方针对于改善医疗管理结果和为患者提供选择至关重要.
- 建议定期进行审计和反,以加强遵守既定方案,包括抗生素预防.
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