[Perinatal medical possibilities and limitations of the obstetrical center--an analysis of the causes of perinatal mortality 1982-1985].
Based on the analysis of 4,881 deliveries during 1982-1985 the perinatal statistical data of a regional perinatal center (level 3) are presented. There is high percentage of pregnancies at risk (57%), preterm deliveries (11%), and increasing incidence of multiple pregnancies (3%). The rate of spontaneous deliveries amounts to more than 70%, the frequency of cesarean sections reached a maximum of 19%. As causes of 82 perinatal deaths (16.8% mortality rate) were found above all fetal malformations (42%), multiple pregnancy (18%), severe intrauterine growth retardation (17%), and premature rupture of membranes with septic complications (10%). Further causes of perinatal death were severe umbilical cord complications (5%), diabetic pregnancy (5%), abruptio placentae and maternal high risks. After detailed analysis 55% of all perinatal deaths proved to be unavoidable, 18% possibly avoidable, and 27% avoidable. The presentation of the avoidable perinatal deaths demonstrates the shortcomings and possible improvements of the obstetrical management and organization. The possibly avoidable cases could be solved in future. According to the purged perinatal mortality rate there are 4 remaining avoidable cases for which the perinatal center proved to be responsible. The perinatal mortality risk in the regional center is therefore less than 1%o.
D000013:Congenital Abnormalities / Q000401:mortality; D005260:Female; D005860:Germany, West; D006771:Hospitals, Maternity; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000401:mortality* / Q000517:prevention & control; D007235:Infant, Premature, Diseases / Q000401:mortality; D007744:Obstetric Labor Complications / Q000401:mortality* / Q000517:prevention & control; D007752:Obstetric Labor, Premature / Q000401:mortality; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality* / Q000517:prevention & control; D011272:Pregnancy, Multiple; D012306:Risk
Perinatalmedizinische Möglichkeiten und Grenzen des geburtshilflichen Zentrums--eine Analyse der Ursachen perinataler Mortalität 1982-1985.