Abstract
It has recently been demonstrated that about 56 percent of patients delivering in a rural obstetric unit had significant risk factors, and that 85 percent of these could have been detected by meticulous antenatal screening before the onset of labour. These figures show that the average rural obstetric unit in South Africa is dealing with a large percentage of high risk patients. In this work, it is hampered by: 1. Communications problems: i.e. bad roads, long distances. and unpredictable telephones. 2. A serious shortage of medical staff resulting in primary obstetric care being delivered by midwives with minimal medical supervision.
Highlights
’n Stelsel van probleemgerigte aantekeninge t.o.v. voorgeboortesorg word beskryf
IINTRODUCTION TperHcAenSt orfepcaetnietlnyts bdeeleinverdinegmoinnastrruartaeldobtshtaettricabuonuitt h5a6d significant risk factors, and that 85 percent of these could have been detected by meticulous antenatal screening before othbestoentsriect ounf iltabinouSro.uTthheAsefrfiicgauirsesdesahloiwngthwaitththae laavregreagpeerrcuernalt1a.ge Coof mhimghunriicsaktipoantsienptrso.blIenmtsh:is iw.eo. rkb,adit riosahdasm, pleornegd dbiys:
Admit waiting area at 36 weeks. woIumldmiendcilautdee aacdtiiosncusastiothneascltionwichylevheolspiintalthdieslipvaetriyenist ancecceepsstianrgy,tuabnadl lfiigramtiomn.otTivhaetitohnirdoflintheeinpraeticeonmt mtoewnadrad tions would be filled in by the doctor once his decision about the timing and route of delivery of the patient has been made. This system of notekeeping has a number of important advantages for a community obstetric programme: 1. rtIhteefherenrleipnwsg micnleindaiiccchaialenvodifnfbgiacsecerl,ehauornspfcaiotmamli.lmiaIutrniwsicioatbhtivotinhoseusmbeeavtnweanegeteno ment policies of the unit why, he patient is referred and who is expected to look after her on arrival in the 2. hTohsepimtaild. wTihfies rraepsuidltlsy inbeacmomucehs hfaigmhielriasrtawnidtahrdtroeaftcmaeren.t protocols because she is constantly initiating them
Summary
’n Stelsel van probleemgerigte aantekeninge t.o.v. voorgeboortesorg word beskryf. Dit bevorder kommunikasie tussen verwyskliniek en basishospitaal en is ’n help by die opleiding van die kliniekvroedvrou. It omisbaslltoegmtirceicadlicctaaorleesxubppeeiecnrtvgitshdiaeotlniev.aerrleyd by midwives with mini detection of the antenatal patient at risk will greatly improve the care which can be o231f...ferWbbeSMdeeeoafleonrtvhncreeeetecdededcptsoeoasatamfairorelpywrny.ltaisicinpbtaieettnhcicgoeiaanumplssroeeadtgtehstnveehanerenstlioc'copyaan.nrtehfabaretoi:nmhoosrtphnieetaalrddotheceltiovhreo,rsypoifwttaeilln,l ahnodspitthaulsfrboem ntehaeroennseotugohf latoboruerc.eiIvnea ocpittyimcaolmcmaurenitiyn obstetric programme, the patient can be transferred timeously to the antenatal clinic at the base hospital for continued care. A Tdihaegnaiomsisofbtlhoicskbl(osecek Fisigtoureenc1o)urage the midwife to erespvieecwialtlhyeapt a3t6ie-n3t8'swreeeckosr,d wcrhietincatlhley daetceisaicohn vaissitto, bthuet place of delivery must be made for most patients. Such a review must constitute an intelligent appraisal of the wtohgoelteherrecmoradk,e louopkainmg afojorrpraitstkernfascotofrf.acFtoorrsewxahmicphlem: ay December 1978
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