Main Tasks of Czech Perinatology at the Beginningof the 21st century

Overview

Objective:
To identify the main goals of the Czech perinatology at the beginning of the21st century.Design: Retrospective epidemiologic analysis of selected perinatal care quality indicators.Setting: Institute for the Care of Mother and Child, Prague.Methods: Analysis of selected indicators of perinatal care and their trends in the Czech Republicand comparison with other countries.Results: When we reached the same low level of perinatal mortality as the other most developedcountries, we have observed unchanged values for last three years. The priorities established 15years ago are still important to preserve the current situation, however the further developmentin perinatology requires now goals related to development of selected indicators of perinatal careand their international comparisons. These are: 1) change of defi nition of stillbirth includingnewborns of 500-999 grams (currently registered as spontaneous abortions), 2) termination ofthe continuous increase of Caesarean section, 3) inclusion of the criteria of quality of perinatalcare, especially a) deaths during late neonatal and postneonatal periods with perinatal causes; b)perinatal morbidity (impaired neuro-sensoric and psychological development of the child due toperinatal causes). Both these tasks will require collaboration of professionals from obstetrics andneonatology with specialists from other fi elds.Conclusions: The 4 main tasks were established on the basis of development of selected perinatalcare quality indicators and their international comparisons: the chage of defi nition of stillbirth,the termination of continuous increase of Caesarean sections, and inclusion of other indicators ofperinatal care, fi rst related to mortality after 7th day of life due to perinatal causes, and second theperinatal period related morbidity in later periods of infant life.

Key words:
Caesarean section, defi nition of stillbirth, infant mortality, perinatal morbidity, congenitalmalformations