Georgsdóttir I, Geirsson R T, Jóhannsson J H, Biering G, Snaedal G
Department of Obstetrics and Gynecology, University of Iceland, National University Hospital, Reykjavik.
Acta Obstet Gynecol Scand. 1989;68(2):109-12. doi: 10.3109/00016348909009896.
In a retrospective study of all perinatal and neonatal deaths in Iceland in 1976-85, the circumstances surrounding each death were carefully evaluated to assess the quality of care given and to identify cases of suboptimal care. In 1976-80, 87 or 35% of peri- and neonatal deaths were associated with suboptimal care and 46 or 29% of peri- and neonatal deaths in 1981-85. Most of the infants weighed more than 1500 g. Suboptimal care was most commonly seen in conjunction with antenatal care in both five-year periods, with a 25% (N.S.) reduction of cases in 1981-85. Suboptimal intrapartum care was significantly reduced (p less than 0.05) and there was a substantial reduction (62%), although not significant (0.1 greater than p greater than 0.05), of suboptimal neonatal care between the two periods. A few cases were attributable to maternal decisions taken against medical advice, most of them in the latter period. Perinatal care improved during the study period. The task of further lowering perinatal mortality rates depends on vigilance to abnormal findings in routine antenatal care.
在一项对1976年至1985年冰岛所有围产期和新生儿死亡病例的回顾性研究中，对每例死亡的相关情况进行了仔细评估，以评估所提供护理的质量并确定护理欠佳的病例。在1976年至1980年期间，87例（占围产期和新生儿死亡病例的35%）与护理欠佳有关，在1981年至1985年期间，这一数字为46例（占29%）。大多数婴儿体重超过1500克。在这两个五年期间，护理欠佳最常见于产前护理环节，1981年至1985年期间病例数减少了25%（无统计学意义）。产时护理欠佳的情况显著减少（p<0.05），两个时期之间新生儿护理欠佳的情况大幅减少（62%），尽管不显著（0.1>p>0.05）。少数病例可归因于产妇违背医嘱所做的决定，其中大多数发生在后期。在研究期间，围产期护理有所改善。进一步降低围产期死亡率的任务取决于在常规产前护理中对异常情况保持警惕。
