日本未熟児新生児学会雑誌　第21巻　第2号　125～130頁（2009年）

日本未熟児新生児学会雑誌　21(2)：301-306；2009　

受付日：平成20．02．15

受理日：平成21．03．26

東京都立大塚病院におけるハイリスク妊婦への産前訪問の取り組み

An Action of Prenatal Visit for High-risk Pregnant Woman in Our Hospital

東京都立大塚病院　新生児科

Department of Neonatology, Tokyo Metropolitan Ohtsuka Hospital

増永　健・岡田真衣子・大橋祥子・藤中義史・岩村美佳・瀧川逸朗

Ken MASUNAGA，Maiko OKADA，Shoko OHASHI， Yoshifumi FUJINAKA，Mika IWAMURA，Itsurou TAKIGAWA

Key Words：prenatal visit，NICU，high-risk pregnant woman

　当院産科に入院している妊婦のうち妊娠22週以降で希望した妊婦に対し，新生児科医師とNICU看護師が産前訪問を行った。医師がその週数で出生した場合の一般的な児の状態や治療の流れ，予後などについて，看護師が看護ケアの1日の流れ，NICU内の写真，カンガルーケアなどについて30分から1時間程度で説明した。
　2003年4月から2004年9月の1年6か月間に計39組に産前訪問を行った。妊婦の年齢は23～41歳で25名が初産婦であり，27名が切迫早産などで当院へ緊急母体搬送されていた。訪問時の週数は24～37週で，出産した週数は24～39週，出生体重は590～2,965gであった。多胎は14組であった。出生児は計57名でNICUに入院したのは23名，GCUに入院したのは18名であった。ハイリスク妊婦に対する産前訪問は保護者の不安の解消に有用であり，周産期母子医療センターでは必須のものと思われた。

　The prenatal visit for high-risk pregnant women become more important recently because of smooth acceptance of baby. We visited to obstetric inpatients with the fetus and their family of possibility to be hospitalized in NICU after delivery who was hospitalized in obstetrics ward of Tokyo metropolitan Ohtsuka hospital. The team consists of a neonatologist, a nurse of NICU and a midwife of maternity ward visited at patient’s room and provides them with the information about the care and the treatment for their babies in NICU. We answered any question of the mother. On average, 30-60 minutes were required for explanation and answering the questions from each patient and their family. A total of thirty-nine prenatal visits were made from April, 2003 to September, 2004. At the time of visit, the gestational age of patients were between 24-37 weeks. Maternal age ranged from 23 to 41 years old, and 25 women were primipara, 27 patients were admitted to our hospital by emergency maternal transport because of threatened premature delivery, nine patients underwent once or several times of infertility therapy. The babies of those patients were born at 24-39 weeks of gestation. There were 57 live-born babies of these high risk mothers in this period. Among 57 babies, 41 were hospitalized to NICU ward. Our prenatal visit was very useful for solution of uneasiness of high-risk pregnant woman and her family. It seems that this type of prenatal visit is essential to neonatal and maternal tertiary care centres.