Ankara Ambulans Servisine Başvuran Hastane Dışı Doğumların Retrospektif İncelenmesi

Year 2025, Volume: 6 Issue: 1, 46 - 50, 31.01.2025

Seray Kaya , Burak Bekgöz , Burhan Albay

https://doi.org/10.47482/acmr.1588137

Abstract

Amaç: Hastane öncesi acil sağlık hizmetlerinde, hastane dışı doğumlar(HDD) nadirdir ancak istisnai bir durum değildir. Çalışmamız Ankara ilinde HDD yapmış hastaların verilerini değerlendirmeyi ve hastane öncesi obstetri organizasyonunu analiz etmeyi amaçlamaktadır.
Yöntem: Çalışmamızda, 2021 ile 2023 yılları arasında Acil Sağlık Otomasyon Sistemi(ASOS) kayıtları üzerinden Ankara genelinde HDD yapmış ve hastaneye ambulans ile nakledilmiş 403 gebenin başvuru yaş, uyruk, başvurduğu ilçe, nakledilen hastane türü ve uluşım süresi verileri incelemektedir.
Bulgular: 2021-2023 yılları arasında Ankara İl Ambulans Servisi toplam 403 HDD olgusuna müdahale etmiştir. Hastaların 214’ü (%53,1) Türkiye Cumhuriyeti vatandaşı iken 189’u (%46,9) yabancı uyrukludur. HDD yapan yabancı anneler en fazla Ortadoğu ve Asya kökenliydi. Çalışmamızdaki annelerin ortalama yaşı 26,9 ± 5,7’dir. Yıllara göre perifer bölgelerden HDD başvurularında anlamlı fark bulunmuştur. 2021 yılında 13 (%14,6) olgu, 2022 yılında 62 (%36,3) olgu ve 2023 yılında 52 (%36,4) olgu başvurmuştur.
Sonuç: olarak iyi kurgulanmış bir hastane öncesi acil obstetrik bakım organizasyonu ile hastalara daha ulaşılabilir ve iyi bir acil sağlık hizmeti sunumu gerçekleştirilebilir. Demografik yapıdaki yabancı hasta sayısının artışı HDD sayısını artırabilir.

Keywords

Hastane dışı doğumlar, Prehospital, obstetri

Retrospective Analysis of Out-of-Hospital Births in Ankara Emergency Medical Services

Abstract

Background: In Emergency Medical Services (EMS), out-of-hospital (OOH) births are rare but not exceptional. Our study aims to evaluate the data of patients who gave birth in OOH in Ankara province and to analyze the prehospital obstetric organization.
Methods: We evaluated the records (such as age, nationality, district, type of hospital to which they were transported, and transportation time) in the ASOS database of 403 pregnancies who gave birth outside the hospital in Ankara between 2021 and 2023 and were transported to a hospital by ambulance.
Results: Between 2021 and 2023, Ankara EMS intervened in a total of 403 out-of-hospital (OOH) birth cases. While 214 (53.1%) of the patients were citizens of the Republic of Türkiye, 189 (46.9%) were foreign nationals. Foreign nationals who gave birth at OOH were mostly of Middle Eastern and Asian origin. The mean age of the mothers in our study was 26.9 ± 5.7 years. A significant difference was found in the incidence of OOH births in peripheral regions between years. While there were 13 (14.6%) cases in 2021, there were 62 (36.3%) cases in 2022 and 52 (36.4%) cases in 2023.
Conclusions: With a well-designed EMS obstetric care organization, patients can be provided with more accessible and better service. The increase in the number of foreign nationals in the demographic structure may increase the number of OOH births.

Keywords

Out-of-hospital births, Pre-hospital, obstetrics

References

• Bagou G, Mercier FJ, Vivien. Out-of-hospital unexpected delivery. Anaesth Crit Care Pain Med. 2016;35: S23-S26.
• McLelland GE, Morgans AE, McKenna LG. Involvement of emergency medical services at unplanned births before arrival to hospital: a structured review. Emerg Med J. 2014;31(4):345-350.
• Rodie V, Thomson A, Norman J. Accidental out-of-hospital deliveries: an obstetric and neonatal case control study. Acta Obstet Gynecol Scand. 2002;81(1):50-54.
• Cash RE, Kaimal AJ, Samuels-Kalow ME, Boggs KM, Swanton MF, Camargo CA Jr. Epidemiology of emergency medical services-attended out-of-hospital deliveries and complications in the United States. Prehosp Emerg Care. 2023;1-8.
• Tintinalli JE, Stapczynski JS, Ma OJ, Yealy DM, Meckler GD, Cline DM. Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 8e. Vol 18. McGraw Hill Education; 2016. p. 340-344.
• Ovaskainen K, Ojala R, Gissler M, Luukkaala T, Tammela O. Out-of-hospital deliveries have risen involving greater neonatal morbidity: risk factors in out-of-hospital deliveries in one University Hospital region in Finland. Acta Paediatr. 2015;104(12):1248-52.
• Diana L, Glaucia L, Adriana C, Israel F Jr. Out-of-hospital deliveries: a case-control study. Turk Pediatri Ars. 2018;53(2):87-95.
• Svedberg E, Strömbäck U, Engström Å. Women's experiences of unplanned pre-hospital births: a pilot study. Int Emerg Nurs. 2020; 51:100868.
• Unterscheider J, Ma’ayeh M, Geary MP. Born before arrival births: impact of a changing obstetric population. J Obstet Gynaecol. 2011; 31:721-723.
• Khazaei A, Esmaeili M, Navab E. The most and least stressful prehospital emergencies from emergency medical technicians' viewpoint: a cross-sectional study. Arch Acad Emerg Med. 2019;7(1): e20.
• Verdile VP, Tutsock G, Paris PM, Kennedy RA. Out-of-hospital deliveries: a five-year experience. Prehosp Disaster Med. 1995;10(1):10-3.