ABSTRACT
OBJECTIVE: To develop a telephone score predicting imminent delivery. METHODS: Prospective multicenter (n=38) study including pregnancies of 33 weeks or more amenorrhea (n=3.499). Values in points were assigned to risk factors (Cox's model) and the score tested on a validation cohort and receiver operating characteristic curves. RESULTS: Risk was increased if the caller was panicking or declared delivery to be imminent (+3 points), if the pregnant woman could not be spoken to herself (+3), was aged 26-35 (+3) years, was having frequent contractions (from +4 to +8), had the urge to push (+2 to +6 depending on starting time), had a history of rapid or home delivery (+2), or had not been followed up during pregnancy (+8). Nulliparous women (-7) or those on tocolytic treatment (-3) were less at risk. The score is reproducible and relevant. CONCLUSION: Score predicting imminent delivery scoring during calls is a valid means of assessing risk of delivery.
Subject(s)
Emergency Medical Services , Labor Stage, Third , Severity of Illness Index , Telemedicine , Adolescent , Adult , Cohort Studies , Female , Humans , Interviews as Topic , Middle Aged , Pregnancy , Risk , Sensitivity and Specificity , Young AdultABSTRACT
OBJECTIVE: Unintentional drowning is an important public health problem. Effective prevention measures require detailed knowledge of the specific epidemiology of fresh water drowning and near-drowning incidents. METHODS: We analyzed statistics about these incidents in Isère (district in southeastern France) from 1996 through 2003. Data came from district emergency medical services (SAMU) and from hospitals. RESULTS: There were 101 drowning incidents (1.3 per 100,000 person-years), 77% involving males and 23% females. Mortality was high (38%) and involved mainly males (90%). Natural water bodies were the site of many cases (39%) and the associated mortality rate was high (69%). These cases raise specific problems of prevention and assistance to victims. Drowning incidents occurred most commonly (49%) in swimming pools and involved mainly children (82%), but mortality was lower (20%) in these cases. The remaining cases (12%) took place in bathtubs and involved mainly children (75%). The mortality rate for these was relatively low (14%). CONCLUSION: Only prevention measures that fully take into account the different characteristics of each drowning site can reduce the incidence of these events.
