Obstet Gynecol Sci.  2018 May;61(3):289-297. 10.5468/ogs.2018.61.3.289.

Conceptualized framework for levels of obstetric care

Affiliations
  • 1Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea. smleemd@hanmail.net

Abstract

It has been demonstrated that risk-appropriate perinatal and obstetric care can improve perinatal morbidity and mortality. Recently, various studies focus on the importance of evaluation for maternal conditions and allocation of high risk pregnant women to highly qualified facilities. Therefore, it is necessary to develop the conceptualized framework for levels of obstetric care and establish the guidelines for the situations that should be cared in each level of facility. In this review article, we reviewed several classifications of obstetric care in eastern and western countries, and conditions in which transfer should be recommended depending on the risk and capacity of centers.

Keyword

Maternal care; Hospital referral; High-risk pregnancy

MeSH Terms

Classification
Female
Humans
Mortality
Pregnancy, High-Risk
Pregnant Women
Referral and Consultation

Reference

1. Hankins GD, Clark SL, Pacheco LD, O'keeffe D, D'alton M, Saade GR. Maternal mortality, near misses, and severe morbidity: lowering rates through designated levels of maternity care. Obstet Gynecol. 2012; 120:929–934.
2. Gortmaker S, Sobol A, Clark C, Walker DK, Geronimus A. The survival of very low-birth weight infants by level of hospital of birth: a population study of perinatal systems in four states. Am J Obstet Gynecol. 1985; 152:517–524.
Article
3. Paneth N, Kiely JL, Wallenstein S, Marcus M, Pakter J, Susser M. Newborn intensive care and neonatal mortality in low-birth-weight infants: a population study. N Engl J Med. 1982; 307:149–155.
4. Network Indiana Perinatal (US). Revised Indiana perinatal hospital standards [Internet]. Indianapolis (IN): Network Indiana Perinatal;c2015. cited 2015 Jun 16. Available from: http://www.in.gov/laboroflove/files/Perinatal_Hospital_Standards_2015.pdf.
5. Arizona Perinatal Regional System (US). Recommendations and guidelines for perinatal and freestanding neonatal care centers in Arizona. 3rd ed. Casa Grande (AZ): Arizona Perinatal Regional System;2012.
6. Maryland Department of Health and Mental Hygiene Recommendations of the Perinatal Clinical Advisory Committee (US). The Maryland perinatal system standards: revised November 2013 [Internet]. Baltimore (MD): Maryland Department of Health and Mental Hygiene;c2014. cited 2014 Oct 24. Available from: http://phpa.dhmh.maryland.gov/mch/Documents/Maryland_Perinatal_System_Standards_2013.pdf.
7. American College of Obstetricians and Gynecologists and Society for Maternal–Fetal Medicine. Levels of maternal care. Am J Obstet Gynecol. 2015; 212:259–271.
8. The Royal College of Anaesthetists (GB). Providing equity of critical and maternity care for the critically ill pregnant or recently pregnant woman [Internet]. London: The Royal College of Anaesthetists;c2011. cited 2011 Jul. Available from: https://www.rcog.org.uk/globalassets/documents/guidelines/prov_eq_matandcritcare.pdf.
9. Freedman RL, Lucas DN. MBRRACE-UK: saving lives, improving mothers' care - implications for anaesthetists. Int J Obstet Anesth. 2015; 24:161–173.
Article
10. Hasegawa J, Sekizawa A, Tanaka H, Katsuragi S, Osato K, Murakoshi T, et al. Current status of pregnancy-related maternal mortality in Japan: a report from the Maternal Death Exploratory Committee in Japan. BMJ Open. 2016; 6:e010304.
Article
11. Unno N. The perinatal care system in Japan. Japan Med Assoc J. 2011; 54:234–240.
12. Park WS. Development of national patient transfer system for the integrated approach in high-risk mother and infant care. Cheongju: Ministry of Health and Welfare;2015.
13. Lee G. Establishment of health care delivery system between the integrated center for high-risk pregnant women and neonates and the maternity care in the underserved area. Cheongju: Ministry of Health and Welfare;2015.
14. American College of Obstetricians and Gynecologists' Committee on Obstetric Practice. Committee opinion no. 667: hospital-based triage of obstetric patients. Obstet Gynecol. 2016; 128:e16–e19.
15. Wright JD, Herzog TJ, Shah M, Bonanno C, Lewin SN, Cleary K, et al. Regionalization of care for obstetric hemorrhage and its effect on maternal mortality. Obstet Gynecol. 2010; 115:1194–1200.
Article
16. Olive EC, Roberts CL, Algert CS, Morris JM. Placenta praevia: maternal morbidity and place of birth. Aust N Z J Obstet Gynaecol. 2005; 45:499–504.
Article
17. American Academy of Pediatrics. The American College of Obstetricians and Gynecologists. Guidelines for perinatal care: seventh edition [Internet]. Elk Grove Village (IL): American Academy of Pediatrics;c2012. cited 2012 Oct 29. Available from: http://www.circulomedicodezarate.org/e-books/Guidelines_for_Perinatal_Care.pdf.
18. Angelini DJ, Mahlmeister LR. Liability in triage: management of EMTALA regulations and common obstetric risks. J Midwifery Womens Health. 2005; 50:472–478.
Article
19. Korean Society of Maternal Fetal Medicine. Definition of high-risk pregnancy [Internet]. Seoul: Korean Society of Maternal Fetal Medicine;c2015. cited 2015 Mar 18. Available from: http://www.ksmfm.or.kr/bbs/index.html?code=pds&number=158&mode=view.
20. Korean Society of Obstetrics and Gynecology. Classification of high-risk pregnancy [Internet]. Seoul: Korean Society of Obstetrics and Gynecology;c2017. cited 2017 Jan 2. Available from: http://ksog.org/bbs/?code=notice&mode=view&number=3849.
21. Ministry of Health (NZ). Guidelines for consultation with obstetric and related medical services (referral guidelines) [Internet]. Wellington: Ministry of Health;c2012. cited 2012 Feb. Available from: https://www.health.govt.nz/system/files/documents/publications/referral-glines-jan12.pdf.
22. Xu X, Siefert KA, Jacobson PD, Lori JR, Ransom SB. The impact of malpractice burden on Michigan obstetrician-gynecologists' career satisfaction. Womens Health Issues. 2008; 18:229–237.
Article
23. Xu X, Siefert KA, Jacobson PD, Lori JR, Gueorguieva I, Ransom SB. Malpractice burden, rural location, and discontinuation of obstetric care: a study of obstetric providers in Michigan. J Rural Health. 2009; 25:33–42.
Article
24. Mann S, McKay K, Brown H. The maternal health compact. N Engl J Med. 2017; 376:1304–1305.
Article
25. National Medical Center (KR). Study on medical institution model and management plan based on deriving medical vulnerable area [Internet]. Seoul: National Medical Center;c2013. cited 2013 Dec 6. Available from: https://www.ppm.or.kr/board/thumbnailList.do?MENUID=A04030000.
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