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Antenatal day care units versus hospital admission for women with complicated pregnancyKröner C, Turnbull D, Wilkinson C
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SummarySome evidence exists that admission to antenatal day care units may help reduce the length of time spent in hospital for women with a complicated pregnancyComplications during pregnancy can include high blood pressure, excessive vomiting, threatened early labour or abnormal and heavy bleeding (haemorrhage). Admission to hospital is necessary but disruptive to the mother and her family. Sometimes this care can be given without the need for an overnight stay in hospital. Day care units can provide a more relaxed atmosphere and better access for families, while still providing high quality medical and midwifery care. The review of trials found some evidence that inpatient stay and the rate of induced labour was reduced by admission to day care units but more research is needed.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2008 Issue 2, Copyright © 2008 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This version first published online:
October 23. 2001 AbstractBackgroundThe use of antenatal day care units is widely recognized as an alternative for inpatient care for women with complicated pregnancy. ObjectivesThe objective of this review was to assess the clinical safety, plus maternal, perinatal and psychosocial consequences for the women and cost effectiveness of this type of care. Search strategyThe Group's Specialised Register of Controlled Trials was searched in May 2001 as well as the Cochrane Controlled Trials Register (CENTRAL/CCTR), CINAHL (1982-04 to 1998-10) and Current Contents (Life Sciences/Clinical Medicine 1995-05 to 1999). Conference proceedings of PSANZ (Perinatal Society of Australia and New Zealand) and FIGO (Fédération Internationale de Gynécologie et d'Obstétrie) (1997) were searched. Selection criteriaRandomized trial comparing day care with inpatient care for women with complicated pregnancy. Data collection and analysisTrial quality was assessed by two reviewers independently. The author of the study was contacted for additional information. Data were extracted by the same two reviewers independently. Main resultsOne trial involving 54 women was included. This trial was of average quality. It was found that day care assessment for non-proteinuric hypertension can reduce inpatient stay (difference in mean stay: 4.0 days; 95% confidence interval (CI): 2.1 to 5.9 days). Also a significant increase in the rate of induction of labour in the control group was found (4.9 times more likely: 95% CI: 1.6 to 13.8). The other clinical outcomes did not show a statistically significant difference between the control and intervention group. No other significant differences were observed. Authors' conclusionsAdmission to day care for non-proteinuric hypertension reduces the amount of time spent in the hospital and proportion of women induced for labour. However, one trial of 54 women is not sufficient to draw sound conclusions. Additional studies are needed to give more solid evidence to confirm the advantages of antenatal day care units. |