Obstetrics and prenatal diagnosis
The regionalization of perinatal care in France — description of a missing policy

https://doi.org/10.1016/0301-2115(95)02107-IGet rights and content

Abstract

This paper reviews published data on the organization and evaluation of regionalized perinatal care programs in countries where they exist and describes those elements presently lacking in France. The advantage of maternal compared to neonatal transport is described vis-85-vis its effect on perinatal deaths as well as neonatal and developmental handicaps. Most studies describe a major advantage of maternal transfers, with less perinatal deaths (including stillbirths and neonatal deaths) and lower rates of severe developmental handicaps. In contrast, French publications show that widespread regionalization of perinatal care does not exist in spite of proposals advocating this concept made more than 20 years ago. Thus, many deliveries of less than 33 weeks gestation length or/and less than 1500 g birth weight take place in maternity sites without adequate neonatal care, despite ample evidence that such infants are at much greater risk of perinatal death or severe handicaps at 2 years of age after transfer than if they had been born in a perinatal center. For these reasons, professional organizations in France should choose to implement a policy of maternal transfers as a major effort in the near future.

References (40)

  • AK Daltveit et al.

    Risikoforhold ved transportfodsler i Norge 1967–1988

    Tidsskr Nor Loegeforen

    (1991)
  • BA Harris et al.

    In utero versus neonatal transportation of high-risk perinates: a comparison

    Obstet Gynecol

    (1981)
  • LAA Kollee et al.

    Maternal and neonatal transport: results of a national collaborative survey of preterm and very low birth weight infants in The Netherlands

    Obstet Gynecol

    (1988)
  • LAA Kollee et al.

    Sterftekans na intra-uterien en neonatal transport

    Ned Tijdschr Geneeskd

    (1989)
  • LAA Kollee et al.

    Five-year outcome of preterm and very low birth weight infants: a comparison between maternal and neonatal transport

    Obstet Gynecol

    (1992)
  • E Lallemand et al.

    L'appel anténatal — Indications — Rôle du SAMU

    Rev Fr Gynecol Obstét

    (1989)
  • A Luttkus et al.

    Sendung von Haüfigkeit und Morbidität sehr untergewichtiger Frühgeborener nach mütterlichem Transport in ein perinatales Zentrum

    Geburtsh Frauenheilk

    (1992)
  • DK Richardson et al.

    Decision analysis of highrisk patient referral

    Obstet Gynecol

    (1984)
  • DM Strobino et al.

    Development of an index of maternal transport

    Med Decis Making

    (1993)
  • PR Swyer

    The original organisation of special care for the neonate

    Ped Clin North Am

    (1970)
  • Cited by (0)

    View full text