[Risk-adapted regionalization of twin deliveries].
BACKGROUND
Twin pregnancies and deliveries are at higher risk of complications such as prematurity, preeclampsia and fetal distress. The level of regionalization in relation to the risk profile was evaluated.


METHODS
The Data of the Perinatal survey of the state of Hesse - Germany of the years 1990-2008 were evaluated according to the type of hospital. Distinctively Perinatal Centres were compare with small (<500 births per anno) and larger (>500 births per anno) community hospitals. The analysers focuses on the degree of adaptation according to a given additional risk in twin pregnancies - prematurity, preeclampsia and diabetes and growth restriction.


RESULTS
Twin pregnancies and deliveries are regionalized in prenatal centres of the State of Hesse in the large majority. Risk adjusted admission is organized in cases of prematurity (<33+0 gestation) and diabetes. In cases of preeclampsia and growth retardation regionalization seem insufficient.


CONCLUSIONS
Further improvement in the case of complicated twin pregnancy is essential to improve fetal and maternal health.
Misselwitz
B
B
Geschäftsstelle Qualitätssicherung Hessen, Eschborn.
Ulrich
S
S
Schmidt
S
S
D015897:Comorbidity; D005260:Female; D005315:Fetal Diseases / Q000401:mortality*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000401:mortality*; D007744:Obstetric Labor Complications / Q000401:mortality*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012041:Regional Medical Programs / Q000706:statistics & numerical data*; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D014427:Twins