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Social obstetrics: non-local expectant mothers admitted through accident and emergency department in a public hospital in Hong Kong.

Authors :
Yung WK
Hui W
Chan YT
Lo TK
Tai SM
Sing C
Lam YY
Lo CM
Lau WL
Leung WC
Source :
Hong Kong medical journal = Xianggang yi xue za zhi [Hong Kong Med J] 2014 Jun; Vol. 20 (3), pp. 213-21. Date of Electronic Publication: 2014 May 09.
Publication Year :
2014

Abstract

Objectives: To review the pregnancy outcomes of non-booked, non-local pregnant women delivering in Kwong Wah Hospital via admission to the Accident and Emergency Department 1 year after the announcement by the Hospital Authority to stop antenatal booking for non-eligible persons; and to perform a literature review of local studies about non-eligible person deliveries over the last decade.<br />Design: Case series.<br />Setting: A public hospital in Hong Kong.<br />Participants: All women who held the People's Republic of China passport or the two-way permit and those non-eligible persons whose spouses were Hong Kong Identity Card holders, who delivered in Kwong Wah Hospital from 1 April 2011 to 31 March 2012.<br />Results: Overall, 219 women who were non-eligible persons delivered 221 live births during the study period. Compared with the annual statistics of Kwong Wah Hospital in 2011, non-local mothers were of higher parity; more likely to have hypertensive disease (including pre-eclamptic toxaemia), preterm deliveries (ie at <37 weeks), babies needing admission to the special care baby unit, and macrosomic babies (ie weighing >4.0 kg). The rates of induction of labour and caesarean section were lower in this group. There was no significant difference in the maternal and neonatal outcomes between women who had no booking and those who had a booking in another Hospital Authority or private hospital. There were many incidents of near-miss obstetric complications or suboptimally managed obstetric conditions due to lack of well-structured and continuous antenatal care in this group of non-eligible persons.<br />Conclusion: Non-eligible person delivering babies in Hong Kong has become a social obstetrics phenomenon. Despite the introduction of policies, reduction in the number of deliveries (quantity) did not improve the obstetric outcomes (quality). Health care professionals should continue to be prepared for managing the potential near-miss clinical complications in this group of 'travelling mothers'.

Details

Language :
English
ISSN :
1024-2708
Volume :
20
Issue :
3
Database :
MEDLINE
Journal :
Hong Kong medical journal = Xianggang yi xue za zhi
Publication Type :
Academic Journal
Accession number :
24812199
Full Text :
https://doi.org/10.12809/hkmj134181