Antenatal day care units versus hospital admission for women with pregnancy complications

Many women experience complications during pregnancy such as high blood pressure, threatened early labour or abnormal and heavy bleeding (haemorrhage). Admission to hospital may be necessary but can be disruptive to the mother and her family. Often tests and monitoring are needed so that the condition of the mother and baby can be assessed and treatment can be provided. Sometimes this care can be given in day care units to avoid the need for an overnight stay in hospital. The review compares day care units with hospital admission or routine care. Three trials, involving 504 pregnant women with high blood pressure or preterm prelabour rupture of the membranes, were included in the review. The findings were that women receiving day care had to make more visits to hospital as outpatients but were less likely to stay in hospital overnight. Care in day units did not seem to affect other outcomes for mothers and babies or increase or reduce interventions in labour; although women in one trial were less likely to have their labours induced if they received day care. Two studies provided evidence that women preferred day care to hospital admission and no women expressed a preference for more inpatient care; most women in both groups felt they had received good care and were satisfied with it.

The aim of antenatal care is to reduce adverse outcomes for mothers and babies but these are relatively infrequent and could not be investigated in this review. A proportion of women attending for day care require subsequent inpatient care, and a range of non‐medical considerations such as travelling distance to emergency facilities, social factors and women's emotional wellbeing may lead to admission to hospital. All studies included in the review were carried out as part of evaluations of new services.