Perinatal Care in the CR in 1997 and Perspectives forthe Near Future - I. National Analysis

Overview

From an analysis of the four main components of perinatal mortality, participating inits gradual decline to the value of 5.1‰ in 1997 ensued that the ratio of three of them, i.e. inborndefects incompatible with life, stillbron neonates with a birth weight of 2000 g or more andneonates with birth weight of 1000 g or more who die after delivery, declined in recent years onlyminimally despite the use of expensive diagnostic and therapeutic procedures, incl. the increasedrate of Caesarean sections. A continual decline of morbidity was noted only in neonates weighingless than 1000 g due to the high percentage taken before delivery to perinatological centres anddue to the marked decline of specific early neonatal mortality of these neonates in some of thesecentres. Improvement of this care in other centres is a reserve for a further decline of the perina-tal mortality but only of the order of tenths pro mille. Therefore in future it will be necessaryto change priorities and focus them on the effectiveness but also usefulness of expansivediagnostic and preventive and therapeutic procedures and on the long-term follow up of allrisk neonates with the objective of early assessment and subsequent prevention of theirperinatal morbidity

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