Iffy L, Apuzzio J, Glista B, Adhate A, Hopp L, Josimovich J
University of Medicine and Dentistry of New Jersey, Perinatal-Neonatal Center, Newark.
Orv Hetil. 1990 Jun 24;131(25):1343-7.
The study presents an overview of the changes in perinatal mortality rates at the Statewide Perinatal Center of New Jersey during the past decades. According to the data, the increase in the rate of cesarean sections from 4.5 percent to 17 percent, and the comparable reduction of the rates of manipulative intrapartum and extraction procedures, contributed significantly to the decrease of the perinatal mortality rates from 51/1000 to 17/1000 between 1971 and 1983. Of the new technical tools, those utilized for the evaluation of fetal well-being antepartum appeared to be more useful then those used intrapartum. On account of the high prevalence of genital infections in the population, the recent acceptance in the service of the use of invasive intrapartum technology, appears to have impacted unfavorably upon the perinatal mortality trends. The increased rate of births of premature babies, the widespread abuse of habit forming drugs in the community, and the routine use of procedures requiring artificial rupture of the membranes, probably all contributed to the rapid increase of the perinatal mortality rate in the Center from 15/1000 in 1986 to 28/1000 in 1988. It is concluded that perinatal care is a complex medical and social task. The overall result of the relevant efforts depends to a great extent upon the social environment, and the moral standing, educational level and motivation of the recipients.
该研究概述了新泽西州全州围产期中心在过去几十年中围产期死亡率的变化情况。根据数据,剖宫产率从4.5%上升到17%,同时助产操作和牵引术的比率相应下降,这在很大程度上促使1971年至1983年间围产期死亡率从千分之51降至千分之17。在新技术工具中,用于产前评估胎儿健康状况的工具似乎比产时使用的工具更有用。由于人群中生殖器感染的高患病率,近期在该服务中采用侵入性产时技术似乎对围产期死亡率趋势产生了不利影响。早产婴儿出生率上升、社区中对成瘾药物的广泛滥用以及常规使用需要人工破膜的操作,可能都导致了该中心围产期死亡率从1986年的千分之15迅速上升到1988年的千分之28。研究得出结论,围产期护理是一项复杂的医学和社会任务。相关努力的总体结果在很大程度上取决于社会环境以及接受护理者的道德水准、教育水平和积极性。