Clinical Practice Guideline for Giving Birth before Arrival in Urban City

Abstract

Birth before arrival is a state of emergency that is likely harmful to mother and newborn, such as postpartum hemorrhage and infection as a result of severe perineum and vaginal trauma. Furthermore, several adverse neonatal outcomes are commonly found among birth before arrival to the hospital, such as birth asphyxia, birth injury, cerebral hemorrhage, polycythemia, and infection. Bangkok is considered an urban area with a high population. Thus, traffic jam is commonly seen in Bangkok that may cause women giving birth before arriving at the hospital because they are stuck on the road. This Clinical Practice Guideline of Birth before Arrival consists of antepartum, intrapartum and postpartum care. (1) In antepartum care, the team should be able to assess and help pregnant women, giving birth outside the hospital. (2) In intrapartum care, the team should follow the Clinical Practice Guideline for giving Birth before Arrival of Thai association for emergency medicine. (3) In postpartum care, the team should keep warm newborn immediately with spontaneous placenta delivery. Doctor, nurse-midwife, paramedic, advanced emergency medical technician, emergency medical technician, and emergency medical responder are the team who have a responsibility to care for women with birth before arrival. Clinical Practice Guideline for Birth before Arrival needs the team who can clamp umbilical cord without cutting the umbilical cord and also take the woman to the hospital immediately.