Author(s): JANUSZ MIRO?CZUK, JOANNA HO?DY, ADELINA ABDEL-AZIZ, MACIEJ KINALSKI
Introduction. Perinatal care includes all activities aimed at ensuring the mother, fetus/neonate proper care in therapeutic procedures during pregnancy, labour and the puerperium including the health promotion. To gain an advantage from knowledge and work in a multidisciplinary medical team was introduced the three-level model of perinatal care. Aim. The aim of the study was to analyze the viability of the III-level reference perinatal care in the hospitals of the Podlaskie voivodship in the period 2004-2008. Material and methods. Analysis of perinatal mortality was based on data from questionnaires. Questionnaires concerned the same data as document MZ-29 from section X and were completed by doctors. Analysis was limited to the presentation of tables and results. Results. Analysis of the perinatal improvement care program throughout the years 2004-2008 indicated the reduction of perinatal death rates (body weight > 500 g) on the first level of reference. In hospitals with the first level of reference this rate decreased from 4,2 ‰ in 2004 to 2,5 ‰ in 2008. It seems that on the first level of reference can be noticed its decline, on the second and third level of reference its growth can be noticed. Number of birth in fetuses and neonates with birth weight, 500-1499 g through the years 2004-2008, on the third level of reference is maintained at the same level. The second level was highest in 2007- 54 and the lowest was 29 in 2008. The most varied number of labours was on the first level. It ranged from 19 in 2005 to 5 in 2008. Small number of neonates« deaths with birth weight 1500-2499 g the first-level hospitals, as well as the perinatal mortality on level 21,6 ‰, shows that the labours took place according to the assumptions of the program in the second (1194 births) and third (603 births) degree reference. Conclusions. Perinatal mortality rate in Podlaskie Voivodeship in the years 2004-2008 on the first level of reference was below the national average. Further reduction rate can be achieved by the improvement of the ambulatory care during pregnancy.