[Risk-adapted regionalization of twin deliveries].

Authors :: Misselwitz B
Ulrich S
Schmidt S
Source :: Zeitschrift fur Geburtshilfe und Neonatologie [Z Geburtshilfe Neonatol] 2009 Dec; Vol. 213 (6), pp. 263-6. Date of Electronic Publication: 2010 Jan 22.
Publication Year :: 2009
Abstract: Background: Twin pregnancies and deliveries are at higher risk of complications such as prematurity, preeclampsia and fetal distress. The level of regionalization in relation to the risk profile was evaluated.<br />Methods: The Data of the Perinatal survey of the state of Hesse - Germany of the years 1990-2008 were evaluated according to the type of hospital. Distinctively Perinatal Centres were compare with small (<500 births per anno) and larger (>500 births per anno) community hospitals. The analysers focuses on the degree of adaptation according to a given additional risk in twin pregnancies - prematurity, preeclampsia and diabetes and growth restriction.<br />Results: Twin pregnancies and deliveries are regionalized in prenatal centres of the State of Hesse in the large majority. Risk adjusted admission is organized in cases of prematurity (<33+0 gestation) and diabetes. In cases of preeclampsia and growth retardation regionalization seem insufficient.<br />Conclusion: Further improvement in the case of complicated twin pregnancy is essential to improve fetal and maternal health.