Theron G B, Pattinson R C, Engelbrecht B H
Department Verloskunde en Ginekologie, Universiteit van Stellenbosch en Tygerberg-hospitaal, Parowvallei, KP.
S Afr Med J. 1988 Feb 20;73(4):211-3.
In this study 18 rural hospitals in the Cape Province were prospectively surveyed in respect of the number of deliveries, perinatal deaths, low-birth-weight babies, and the hospital facilities available for routine antenatal, intrapartum and neonatal care. During the study period (1 January - 31 December 1985) there were a total of 19,274 deliveries (birth weight greater than or equal to 1,000 g). The mean perinatal mortality rate was 27,3/1,000 deliveries (range 15.3-45.3). The prevalence of low-birth-weight babies ranged from 13.3% to 34.4% with a mean of 17.7%. By plotting the perinatal mortality rate against the prevalence of low-birth-weight babies a perinatal care index was established. A low perinatal mortality coupled with a high prevalence of low-birth-weight infants, for example, signifies proper care. The perinatal index was then used to compare the neonatal outcome of different hospitals. Outcome varied considerably, as did facilities and care. Serological tests for syphilis and blood groups were not known in the majority of patients at 4 hospitals involving 2,387 deliveries. No cervical cytology was done at 6 hospitals involving 5,462 deliveries. One hospital had no neonatal resuscitation equipment. There were no facilities for serum bilirubin measurements at 10 hospitals involving 8,867 deliveries. However, most problems identified are easily and cheaply rectifiable.
在本研究中，对开普省的18家乡村医院进行了前瞻性调查，内容涉及分娩数量、围产期死亡情况、低体重儿以及用于常规产前、产时和新生儿护理的医院设施。在研究期间（1985年1月1日至12月31日），共有19274例分娩（出生体重≥1000克）。围产期平均死亡率为27.3‰（范围为15.3 - 45.3）。低体重儿的患病率在13.3%至34.4%之间，平均为17.7%。通过绘制围产期死亡率与低体重儿患病率的关系图，建立了围产期护理指数。例如，低围产期死亡率与高比例的低体重儿表明护理得当。然后使用围产期指数比较不同医院的新生儿结局。结局差异很大，设施和护理情况也是如此。在涉及2387例分娩的4家医院中，大多数患者不知道梅毒血清学检测和血型检测。在涉及5462例分娩的6家医院中未进行宫颈细胞学检查。一家医院没有新生儿复苏设备。在涉及8867例分娩的10家医院中没有血清胆红素测量设施。然而，所发现的大多数问题都易于且廉价地得到纠正。
