title: Social obstetrics: non-local expectant mothers admitted through accident and emergency department in a public hospital in Hong Kong.
abstract: OBJECTIVE
  To review the pregnancy outcomes of non-booked, non-local pregnant women delivering in Kwong Wah Hospital via admission to the Accident and Emergency Department 1 year after the announcement by the Hospital Authority to stop antenatal booking for non-eligible persons; and to perform a literature review of local studies about non-eligible person deliveries over the last decade.
  
  
  METHODS
  Case series.
  
  
  METHODS
  A public hospital in Hong Kong.
  
  
  METHODS
  All women who held the People's Republic of China passport or the two-way permit and those non-eligible persons whose spouses were Hong Kong Identity Card holders, who delivered in Kwong Wah Hospital from 1 April 2011 to 31 March 2012.
  
  
  RESULTS
  Overall, 219 women who were non-eligible persons delivered 221 live births during the study period. Compared with the annual statistics of Kwong Wah Hospital in 2011, non-local mothers were of higher parity; more likely to have hypertensive disease (including pre-eclamptic toxaemia), preterm deliveries (ie at <37 weeks), babies needing admission to the special care baby unit, and macrosomic babies (ie weighing >4.0 kg). The rates of induction of labour and caesarean section were lower in this group. There was no significant difference in the maternal and neonatal outcomes between women who had no booking and those who had a booking in another Hospital Authority or private hospital. There were many incidents of near-miss obstetric complications or suboptimally managed obstetric conditions due to lack of well-structured and continuous antenatal care in this group of non-eligible persons.
  
  
  CONCLUSIONS
  Non-eligible person delivering babies in Hong Kong has become a social obstetrics phenomenon. Despite the introduction of policies, reduction in the number of deliveries (quantity) did not improve the obstetric outcomes (quality). Health care professionals should continue to be prepared for managing the potential near-miss clinical complications in this group of 'travelling mothers'.
authors.affiliation: Department of Obstetrics and Gynaecology, Kwong Wah Hospital, 25 Waterloo Road, Hong Kong.
authors.forename: W K
authors.initials: WK
authors.lastname: Yung
authors.affiliation: Department of Obstetrics and Gynaecology, Kwong Wah Hospital, 25 Waterloo Road, Hong Kong.
authors.forename: Winnie
authors.initials: W
authors.lastname: Hui
authors.affiliation: Department of Obstetrics and Gynaecology, Kwong Wah Hospital, 25 Waterloo Road, Hong Kong.
authors.forename: Y T
authors.initials: YT
authors.lastname: Chan
authors.affiliation: Department of Obstetrics and Gynaecology, Kwong Wah Hospital, 25 Waterloo Road, Hong Kong.
authors.forename: T K
authors.initials: TK
authors.lastname: Lo
authors.affiliation: Department of Obstetrics and Gynaecology, Kwong Wah Hospital, 25 Waterloo Road, Hong Kong.
authors.forename: S M
authors.initials: SM
authors.lastname: Tai
authors.affiliation: Department of Obstetrics and Gynaecology, Kwong Wah Hospital, 25 Waterloo Road, Hong Kong.
authors.forename: C
authors.initials: C
authors.lastname: Sing
authors.affiliation: Department of Paediatrics, Kwong Wah Hospital, 25 Waterloo Road, Hong Kong.
authors.forename: Y Y
authors.initials: YY
authors.lastname: Lam
authors.affiliation: Department of Accident and Emergency, Kwong Wah Hospital, 25 Waterloo Road, Hong Kong.
authors.forename: C M
authors.initials: CM
authors.lastname: Lo
authors.affiliation: Department of Obstetrics and Gynaecology, Kwong Wah Hospital, 25 Waterloo Road, Hong Kong.
authors.forename: W L
authors.initials: WL
authors.lastname: Lau
authors.affiliation: Department of Obstetrics and Gynaecology, Kwong Wah Hospital, 25 Waterloo Road, Hong Kong.
authors.forename: W C
authors.initials: WC
authors.lastname: Leung
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006760:Hospitalization; D006779:Hospitals, Public / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D012189:Retrospective Studies; D014195:Travel
keywords: Emergency service, hospital; Hong Kong; Pregnancy outcome