HIGH-RISK PREGNANCY MONITORED ANTENATALLY AT HOME

Objective: Is domiciliary antenatal fetal surveillance for selected hi gh risk pregnancies, a feasible alternative for hospital admission? De sign: A randomized controlled trial conducted at the Academical Medica l Centre, Amsterdam, The Netherlands. Subjects: Between September 1992 and June 1994, 76 women were at random allocated to domiciliary care and 74 women to hospital care. Criteria for inclusion were hypertensio n (26%), fetal growth retardation (24%), post term pregnancy (23%), di abetes (24%), preterm rupture of membranes (2%) and previous recurrent antenatal death (1%). Main Outcome Measures: Primary outcome measure was perinatal morbidity, measured by Prechtl's neonatal neurological o ptimality score. Secondary outcome variables were the occurrence of co mplications, obstetric interventions at labour, birthweight, gestation al age at delivery and maternal and neonatal admission rates. Results: In both groups there was one case of perinatal mortality. In both tre atment groups the median of the neurological optimality score was foun d at 59. Also secondary outcome variables did not show significant dif ferences. Conclusion: Domiciliary antenatal care for selected women wi th high risk pregnancy is feasible considering obstetric outcome. (C) 1997 Elsevier Science Ireland Ltd.