Svangerskapsomsorg - retningslinjer og praksis

Abstract

The antenatal care program is the largest preventive health care program in Norway. There are approximately 720 000 visits annually, including 60 000 women. The antenatal care model currently in use in Norway is based on NOU 1984: 17; Perinatal omsorg i Norge. For healthy women, eleven visits are recommended when para 0, and seven visits when para 1+. Recent studies have indicated a frequency higher than recommended in the guidelines. In this study, 155 records from the Obstetric Department of Ullevål University Hospital were used to analyse number of antenatal visits. Mean number of visits was 11.8. Factors influencing the frequency were parity and education. Number of visits decreased with para 1+, and increased with higher level of education. In addition, the number of haemoglobin assessments during each pregnancy was registered. Mean number of haemoglobin assessments was 6.1. The frequency of assessments increased with increasing number of visits and with antenatal care performed by general practitioner compared to at health center. During the recent years, an evidence-based antenatal care has been the foundations of international recommendations. In Norway, the Social and Health department has proposed new guidelines for antenatal care. Seven visits are recommended before the 40. gestational week. Routine examinations that have not been proven by research evidence to improve outcomes for women and newborns are excluded. An implementation of the suggested program will probably reduce annual public expenses with approximately 60 million NKR.