Articles: mortality.
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To study the referral patterns of obstetric clinics, and the performance of receiving intensive care units measured by the survival of transported neonates, transport records were collected prospectively between July, 1991 and June, 1992. Two hundred and fifty-four transported neonates born in 51 obstetric clinics (level I units) in Tainan City and County, in southern Taiwan, were enrolled in this study. Nineteen percent of the transported neonates were very low birthweight infants (< 1500 g). ⋯ Approximately 56% of these normal birthweight infants in level II units died of severe birth asphyxia. The referral patterns of level 1 units had an unfavorable effect on the survival of neonates requiring mechanical ventilation. Enhancing the skills of the staff in level I units to recognize and stabilize such infants, elevating the capability of level II units in treating some of these cases, and increasing the hospital beds for level III care are necessary to increase their chance of survival.
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Comparative Study
Impact of mode of delivery on maternal mortality in eclampsia.
Determinants of maternal mortality and causes of death pertaining to mode of delivery have been discussed. There were 23 deaths (case fatality rate of 7.2%) and maximum deaths occurred in intrapartum eclampsia (12 ie, 52.17%). ⋯ Maternal mortality in cases who delivered vaginally was 7.1% (16 out of 225) and 3 cases died undelivered. Authors feel that at the referral centres early caesarean section in eclampsia may help in reducing maternal mortality.
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Maternal mortality ratios in Kasama and Kaputa Districts, two remote rural areas of Northern Province, Zambia, were suspected to be very high. In order to evaluate the impact of a referral system baseline maternal mortality levels and additional maternal mortality risk arising from poor accessibility were estimated. ⋯ This study suggests that solving the accessibility problem would decrease the mortality burden from maternal causes with at least 29% in Kasama District and 65% in Kaputa District.