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首页> 外文期刊>Journal of obstetrics and gynaecology: the journal of the Institute of Obstetrics and Gynaecology >Evaluation of emergency caesarean sections--completion of the audit cycle in a Central London teaching hospital.
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Evaluation of emergency caesarean sections--completion of the audit cycle in a Central London teaching hospital.

机译：评估紧急剖腹产-伦敦市中心教学医院的审核周期完成。

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We set out to complete the audit cycle of caesarean deliveries in order to determine if improvements could be achieved. This was a prospective review of clinical notes in a Central London Teaching Hospital. The study involved 152 women delivering between 18 May and 23 August 1998, and 226 women over the same time period in 1999. For each case, a proforma was completed within 72 hours of delivery. We recorded the total and emergency section rate; indications; decision-to-delivery times; reasons for delay; prescription of ranitidine and heparin; fetal blood samples and cord pH values. The total caesarean section rate decreased from 20.9% to 19.2%. The emergency section rate was unchanged at 14.8% in 1998 (70.9% of total) and 13.6% in 1999 (70.8% of total). Main reasons for emergency sections were failure to progress (59% in 1998, 47% in 1999) and fetal distress (27% in 1998, 34% in 1999). For failure to progress 76% of cases were performed within 1 hour in 1998 vs. 64% of cases in 1999. For fetal distress 39% of cases were delivered within 30 minutes in both years. Fetal blood samples were taken in 41% of fetal distress cases in 1998 and 34% in 1999. Cord pH was documented in 60% of emergency cases in 1998 (96% in 1999). Prescription of ranitidine rose from 53% to 81%. Heparin was well prescribed in both years (88% vs. 87%). Following the initial audit, the total caesarean section rate was significantly lower but there was no difference in the emergency section rate. The implementations had no effect on decision-to-delivery times or use of fetal blood sampling. Improvements were seen in obtaining cord pH values and ranitidine prescription.
机译：我们着手完成剖腹产的审核周期，以确定是否可以实现改善。这是对伦敦市中心教学医院临床笔记的前瞻性评价。该研究涉及152名在1998年5月18日至8月23日之间分娩的妇女，以及226名在1999年同一时期分娩的妇女。对于每种情况，均在分娩后72小时内完成了备考。我们记录了总和急诊科率;适应症;决定交货时间;延误原因;雷尼替丁和肝素的处方;胎儿血样和脐带pH值。剖宫产总率从20.9％降至19.2％。急诊科的比率保持不变，1998年为14.8％（占总数的70.9％），1999年为13.6％（占总数的70.8％）。急诊科的主要原因是无法进展（1998年为59％，1999年为47％）和胎儿窘迫（1998年为27％，1999年为34％）。由于进展不顺利，1998年在1小时内进行了76％的病例，而1999年为64％。在两个年份中，对于胎儿窘迫，有39％的病例在30分钟内分娩。 1998年，在41％的胎儿窘迫病例中采集了胎儿血样; 1999年，采集了34％的胎儿血样。1998年，有60％的紧急病例记录了脐带pH（1999年为96％）。雷尼替丁的处方从53％增加到81％。两年中，肝素的处方良好（88％比87％）。初次审核后，总剖腹产率明显降低，但急诊分娩率没有差异。这些实施对分娩的决定时间或胎儿血样的使用没有影响。在获得脐带pH值和雷尼替丁处方方面已见改善。

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