Document Detail

Discharge against medical advice in an obstetric unit.
MedLine Citation:
PMID:  8320674     Owner:  NLM     Status:  MEDLINE    
Obstetricians have increasingly petitioned courts for orders sanctioning treatment refused by pregnant patients. To speculate on the potential role of forced detention, we reviewed the clinical records of 39 obstetric patients who were discharged against medical advice (AMA) with several diagnoses: preterm labor (27), medical complications of pregnancy (9) and trauma (3). These patients were matched for chronologic age, gestational age and clinical examination at the time of admission and compared to a group of compliant patients who accepted and followed the treatment plan for hospitalization. No perinatal morbidity and/or mortality or other adverse outcome could be documented in the AMA group despite their refusal to continue undergoing admission and therapy. No difference could be demonstrated between the AMA group and the compliant group for obstetric complications, gestational age at delivery, newborn weight and percentage of appropriate-weight-for-gestational-age infants. These data suggest that failure to comply with major obstetric recommendations and hospitalization in these clinical settings might not adversely influence perinatal outcome.
G S Letterie; G R Markenson; M M Markenson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of reproductive medicine     Volume:  38     ISSN:  0024-7758     ISO Abbreviation:  J Reprod Med     Publication Date:  1993 May 
Date Detail:
Created Date:  1993-08-03     Completed Date:  1993-08-03     Revised Date:  2004-11-18    
Medline Journal Info:
Nlm Unique ID:  0173343     Medline TA:  J Reprod Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  370-4     Citation Subset:  E; IM    
Department of Obstetrics and Gynecology, Tripler Army Medical Center, Honolulu, Hawaii.
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MeSH Terms
Judicial Role
Patient Compliance
Patient Discharge*
Pregnancy Outcome*
Pregnant Women*
Risk Assessment
Treatment Refusal*

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