Bör gravide, der ved terminen har formodet vandafgang, og hvor fosterets hoved er höjstående, transporteres liggende til födestedet?
Engelsk titel: Should pregnant women at term with supposed ruptured membranes and unengaged fetal head be transported to the delivery room lying down?
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Författare:
Nikolajsen IL
Email: ilnikolajsen@inet.uni2.dk
Språk: Dan
Antal referenser: 2
Dokumenttyp:
Artikel
UI-nummer: 03121874
Sammanfattning
Introduction: Unengaged foetal head is a predisposing factor to umbilical cord prolapse (UCP). Therefore, if the water should break at home during the last weeks of pregnancy, the normal pregnant woman is often recommended to be brought to the delivery ward lying down in an ambulance. Is horizontal transportation suitable for this group of pregnant women? Materials and methods: A review was done of all delivery records from Sonderborg Hospital that indicated that a woman had presented with UCP; the means of transportation of pregnant women arriving for delivery in the county of southern Jutland in one month was examined; and a questionnaire was sent to all delivery wards in Denmark regarding procedures/traditions and attitudes. Results: During the course of seven years and nine months, eight cases of UCP occurred that were relevant to this study. Only one case of UCP occurred before active labour commenced and before arrival at the delivery ward. Forty-two (20.9%) of the pregnant women were recommended to be brought to the delivery ward lying down if their water should break, but actually only eleven were brought by ambulance. Only one pregnant women, who was transported horizontally, had ruptured membranes and unengaged foetal head. There were no cases of UCP. All delivery wards in Denmark have procedures/traditions recommending horizontal transportation. However, the experts are uncertain as to what the benefit of horizontal transport is. Discussion: The benefit of horizontal transport is unknown, and a prospective randomised trial is impossible. This study reveals that there is very low value in horizontal transport. Each delivery ward must decide if horizontal transport of this group of normal pregnant women should be recommended in the future.