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      Asistencia al parto inminente extrahospitalario. Actuaciones durante este proceso y cuidados a la madre y al recién nacido Translated title: Imminent out-of-hospital birth assistance. Actions during this process and care for the mother and the newborn

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          RESUMEN

          La atención de un parto precipitado que acontece de forma rápida en un entorno que no es el de un centro sanitario especializado siempre es una situación estresante, básicamente por dos motivos, en primer lugar porque las personas implicadas en su atención, aunque están acostumbradas a la asistencia sanitaria urgente no suelen ser especialistas en obstetricia y al manejo del mismo y en segundo lugar, un parto inminente en tal escenario comporta un riesgo potencial tanto de la vida de la madre como del recién nacido si no se actúa de forma rápida y segura; de ahí la utilidad de una guía actualizada en la atención y administración de cuidados a mujeres embarazadas que paren fuera del ámbito hospitalario, tanto a ella como al recién nacido.

          ABSTRACT

          Assisting an unexpected birth that occurs quickly in a setting that is not a specialized health center is always a stressful situation, basically for two reasons; firstly, because the people involved in this type of care, although they are used to urgent health care, are not usually specialists in obstetrics and the management of the same and, secondly, because an imminent delivery within such a scenario involves a potential risk for both the life of the mother and the newborn if there is no quick and safe action; hence the usefulness of an updated guide for the assistance and administration of care to pregnant women who give birth outside the hospital environment, both to her and the newborn.

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          Most cited references18

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          Practice guidelines, a new reality in medicine. II. Methods of developing guidelines.

          Current methods for developing practice guidelines include informal consensus development, formal consensus development, evidence-based guideline development, and explicit guideline development. Informal consensus development is the oldest and most common approach, but guidelines produced in this manner are often of poor quality and lack adequate documentation of methods. Formal consensus development uses a systematic approach to assess expert opinion and to reach agreement on recommendations. Evidence-based guideline development links recommendations directly to scientific evidence of effectiveness; rules of evidence are emphasized over expert opinion in making recommendations. Explicit guideline development clarifies the rationale by specifying the potential benefits, harms, and costs of available interventions; estimating the possibility of the outcomes; and comparing the desirability of the outcomes based on patient preferences. Steps in the development of practice guidelines include introductory decisions (selection of topic and panel members, clarification of purpose); assessments of clinical appropriateness (review of scientific evidence and expert opinion); assessment of public policy issues (resource limitations, feasibility issues); and guideline document development and evaluation (drafting of document, peer review, and pretesting).
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            Accidental out-of-hospital deliveries: a case-control study.

            To determine risk factors for accidental out-of-hospital deliveries (OHDs), which represent 0.5% of live births in France and are associated with poor neonatal outcomes.
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              Mortality in out-of-hospital premature births.

              To determine whether the mortality for out-of-hospital (OOH) premature births was higher than for in-hospital premature births and identify additional risk factors. A historical cohort study of a consecutive series of live-born, OOH, births of 24-35 weeks gestation cared for by two Transport Teams working in and around Paris, France 1994-2005. Matching with in-hospital births was according to gestational age, antenatal steroid use, the mode of delivery and nearest year of birth. Eighty-five OOH premature births were identified, of whom 83 met inclusion criteria, and 132 matching in-hospital premature births were selected. There was 18% mortality in the OOH group compared with 8% for the in-hospital group [p = 0.04, OR 2.9, (CI 95% 1.0-8.4)]. Variables significantly associated (p < 0.05) with the OOH birth were HIV infection, lower maternal age and endo-tracheal intubation, lack of medical follow-up during pregnancy, low temperature and low birth weight. Mortality was more than twice as high in out-of-hospital deliveries than for in-hospital matched controls. Hypothermia was an important associated risk factor. Measures such as oxygen administration to maintain an appropriate saturation for gestational age, the provision of polyethylene plastic wraps and skin-to-skin contact are recommended. © 2010 The Author(s)/Acta Paediatrica © 2010 Foundation Acta Paediatrica.
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                Author and article information

                Journal
                Rev Esp Salud Publica
                Rev Esp Salud Publica
                resp
                Revista Española de Salud Pública
                Ministerio de Sanidad Servicios Sociales e Igualdad
                1135-5727
                2173-9110
                04 September 2018
                Jan-Dec 2018
                : 92
                : e201809063
                Affiliations
                [1 ] original061 Ceuta. Jefa de Estudios de la UD de Matronas de Ceuta. Ceuta. España. orgname061 Ceuta Ceuta España
                [7] orgnameUD de Matronas de Ceuta Ceuta España
                [2 ] originalDepartamento de Enfermería. Universidad de Huelva. Huelva. España. normalizedUniversidad de Huelva orgdiv1Departamento de Enfermería orgnameUniversidad de Huelva Huelva Spain
                [3 ] originalUniversidad Espíritu Santo, Guayaquil, Ecuador. normalizedUniversidad de Especialidades Espíritu Santo orgnameUniversidad Espíritu Santo Guayaquil Ecuador
                [4 ] originalPrograma de Doctorado. Universidad de Almería. Almería. España. normalizedUniversidad de Almería orgdiv1Programa de Doctorado orgnameUniversidad de Almería Almería Spain
                [5 ] originalÁrea Sanitaria Campo de Gibraltar. Cádiz. España. orgnameÁrea Sanitaria Campo de Gibraltar Cádiz España
                [6 ] originalHospital Universitario de Ceuta. UD de Matronas de Ceuta. Ceuta. España. orgnameHospital Universitario de Ceuta orgdiv1UD de Matronas de Ceuta Ceuta España
                Author notes
                Correspondencia: Juan Gómez-Salgado Facultad de Enfermería Universidad de Huelva Campus del Carmen Avda/ Tres de Marzo s/n 21071 Huelva (España) jgsalgad@ 123456gmail.com

                Los autores declaran que no existen conflictos de intereses

                Article
                e201809063
                11587218
                30177677
                79dc2142-4287-4595-93c3-1f92e297a2a9

                This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. You are free to Share (copy and redistribute the material in any medium or format) under the following terms: Attribution (You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use); NonCommercial (You may not use the material for commercial purposes); NoDerivatives (If you remix, transform, or build upon the material, you may not distribute the modified material); No additional restrictions (You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits).

                History
                : 30 March 2018
                : 21 May 2018
                : 04 September 2018
                Page count
                Figures: 16, Tables: 3, Equations: 0, References: 20, Pages: 1
                Categories
                Colaboración Especial

                parto,accidental,extrahospitalario,asistencia,embarazada,delivery,out of hospital,assistance,pregnant

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