title: [Twin pregnancy and labor only at a hospital center?].
abstract: Concentrating the medical risk in hospital centres only is a demand that is being raised time and again, and it may be quite justified to some extent. The question is where to draw the line in respect of best possible medical care. The multiplicity of parameters involved makes it practically impossible to set up a hard-and-fast rule. However, the moral compulsion remains to justify the decision for shouldering a risk, by conducting a quantitative transversal comparative study. We compiled data on pregnancies and twin births at a medium-sized obstetric hospital. A transversal comparison of our results with those of major-size hospital centres justifies that our hospital willingly took the risk of responsibility for twin care: Perinatal mortality is comparatively on the low side with 6.3%, whereas perinatal morbidity as established by studying the pH values, the Apgar scores, and the frequency rate of transferring the twins to the neonatology ward, is quite comparable. The article presents the guidelines laid down by us in respect of supervising parturition in twin births and discusses the enhanced risk and the measures resulting thereform.
mesh_terms: D000046:Academic Medical Centers; D005260:Female; D005323:Fetal Monitoring; D006771:Hospitals, Maternity; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000401:mortality; D007744:Obstetric Labor Complications / Q000628:therapy*; D011247:Pregnancy; D011272:Pregnancy, Multiple; D012306:Risk; D013557:Switzerland; D014427:Twins; D014463:Ultrasonography
vernacular_title: Zwillingsschwangerschaft und -geburt nur in einem Zentrumsspital?