Community-based home-care program for the management of pre-eclampsia: an alternative.
CMAJ
; 149(6): 829-34, 1993 Sep 15.
Article
en En
| MEDLINE
| ID: mdl-8374846
ABSTRACT
OBJECTIVE:
To evaluate the safety, acceptability and cost of a community-based home-care program for the management of mild pre-eclampsia.DESIGN:
A descriptive study of outcomes between Apr. 1, 1985, and Dec. 31, 1989.SETTING:
St. Boniface General Hospital, Winnipeg. PATIENTS Urban Winnipeg residents between 27 and 40 weeks' gestation with mild pre-eclampsia who demonstrated acceptance and compliance with home-care management; 321 patients of 1330 were enrolled in the program.INTERVENTIONS:
Bed rest at home with daily biochemical and biophysical follow-up protocol and weekly clinic visits; patient education; hospital admission for labour, induction, worsening pre-eclampsia or noncompliance with rest at home. OUTCOMEMEASURES:
Patterns of referral to the program; clinical, biochemical and biophysical profiles; incidence of severe complications; reduction in total hospital stay and cost analysis.RESULTS:
As many women were referred from physicians' offices as were referred from the hospital's antepartum unit, the average gestational age at referral being 36 weeks. Most (205 [64%]) of the women were nulliparous. The average length of stay in the program was 11.5 days. The program's availability resulted in a reduction of 2 days (from 5.7 days to 3.7 days) on average in the length of hospital stay when analysed for all 1330 women with pre-eclampsia. Of the 321 patients in the program 137 (43%) were admitted to hospital for worsening pre-eclampsia; severe pre-eclampsia developed 4 days after admission in 9. No patient suffered eclampsia, disseminated intravascular coagulopathy, abruption or fetal loss related to pre-eclampsia while in the program. The estimated cost saving in the management of pre-eclampsia was over $700,000 over the study period.CONCLUSION:
The community-based home-care program is a safe, feasible and less costly alternative to hospital admission in the management of mild pre-eclampsia.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Preeclampsia
/
Servicios de Atención de Salud a Domicilio
Tipo de estudio:
Guideline
Límite:
Female
/
Humans
/
Pregnancy
País/Región como asunto:
America do norte
Idioma:
En
Revista:
CMAJ
Asunto de la revista:
MEDICINA
Año:
1993
Tipo del documento:
Article