Obstetrical triage: stable for discharge.

摘要

Consider these recent cases of women who were sent home after an obstetrical triage evaluation, none of whom were actually stable for discharge. A nulliparous woman at term presented with contractions q 10 minutes lasting 50 seconds and a normal fetal heart rate (FHR) pattern. After 2 hours, contractions were q 6 minutes, lasting 70 seconds, the FHR pattern was normal, and there was no cervical change. The nurse told the patient to come back when contractions were q 5 minutes and her pain was worse. The woman was reluctant to leave as she lived 40 minutes away. The nurse also told the patient that she had seen many other women this evening complaining of false labor and this was likely the result of a change in barometric pressure due to a "storm system coming through" rather than "true" labor. A telephone order for discharge was obtained from the physician. As the woman and her husband were driving home (in the middle of a thunderstorm), she felt intense pelvic pressure, her husband pulled to the roadside and the baby was born. The woman and baby returned to the hospital via ambulance.