title: Impact of the Great East Japan Earthquake on Regional Obstetrical Care in Miyagi Prefecture.
abstract: OBJECTIVE
  The authors report the results of surveys on the emergency transport or evacuation status of obstetric patients conducted in Miyagi prefecture, one of the major disaster areas of the Great East Japan Earthquake and tsunami.
  
  
  METHODS
  The surveys examined the damages to maternity institutions, evacuation status and transport of pregnant women, and prehospital childbirths and were conducted in 50 maternity institutions and 12 fire departments in Miyagi.
  
  
  RESULTS
  Two coastal institutions were destroyed completely, and four institutions were destroyed partially by the tsunami, forcing them to stop medical services. In the two-month period after the disaster, 217 pregnant women received hospital transport or gave birth after evacuation. Satisfactory perinatal outcomes were maintained. Emergency obstetric transport increased to approximately 1.4 fold the number before the disaster. Twenty-three women had prehospital childbirths, indicating a marked increase to approximately three times the number of the previous year.
  
  
  CONCLUSIONS
  In the acute phase of the tsunami disaster, maternity institutions were damaged severely and perinatal transport was not possible; as a result, pregnant women inevitably gave birth in unplanned institutions, and the number of prehospital births was increased extremely. To obtain satisfactory obstetric outcomes, it is necessary to construct a future disaster management system and to re-recognize pregnant women as people with special needs in disaster situations. Sugawara J , Hoshiai T , Sato K , Tokunaga H , Nishigori H , Arai T , Okamura K , Yaegashi N . Impact of the Great East Japan Earthquake on regional obstetrical care in Miyagi Prefecture. Prehosp Disaster Med. 2016;31(3):255- 258.
authors.affiliation: 1Division of Feto-Maternal Medical Science,Department of Community Medical Support,Tohoku Medical Megabank Organization,Tohoku University,Sendai,Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Sugawara
authors.affiliation: 2Department of Obstetrics and Gynecology,Graduate School of Medicine,Tohoku University,Sendai,Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Hoshiai
authors.affiliation: 3Department of Obstetrics and Gynecology,Iwate Prefectural Chubu Hospital,Kitakami,Japan.
authors.forename: Kazuyo
authors.initials: K
authors.lastname: Sato
authors.affiliation: 2Department of Obstetrics and Gynecology,Graduate School of Medicine,Tohoku University,Sendai,Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Tokunaga
authors.affiliation: 2Department of Obstetrics and Gynecology,Graduate School of Medicine,Tohoku University,Sendai,Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Nishigori
authors.affiliation: 4Department of Obstetrics and Gynecology,Keijyu Hospital,Kanazawa,Japan.
authors.forename: Takanari
authors.initials: T
authors.lastname: Arai
authors.affiliation: 5Department of Obstetrics and Gynecology,Tohoku Kohsai Hospital,Sendai,Japan.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Okamura
authors.affiliation: 2Department of Obstetrics and Gynecology,Graduate School of Medicine,Tohoku University,Sendai,Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Yaegashi
mesh_terms: D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D004190:Disasters; D055866:Earthquakes; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D007564:Japan / Q000453:epidemiology; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology; D057192:Tsunamis
keywords: Great East Japan Earthquake; regional obstetrical care; tsunami