Clinical Study on the Delivery of very Low Birth Weight Infants in Iwate Prefecture

  • NISHIJIMA,Mitsushige
    Department of Obstetrics and Gynecology School of Medicine, Iwate Medical University
  • SAITOO,Kozue
    Department of Obstetrics and Gynecology School of Medicine, Iwate Medical University
  • ADACHI,Nobuhiro
    Department of Obstetrics and Gynecology School of Medicine, Iwate Medical University
  • OGASAWARA,Toshihiro
    Department of Obstetrics and Gynecology School of Medicine, Iwate Medical University
  • KUDOO,Tomohiko
    Department of Obstetrics and Gynecology School of Medicine, Iwate Medical University
  • NISHIYA,Iwao
    Department of Obstetrics and Gynecology School of Medicine, Iwate Medical University

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Other Title
  • 岩手県における極小未熟児分娩の臨床的検討

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Abstract

Over the past 4 years, 119 very low birth weight infants (VLBWI, <1,500g) were delivered at Iwate Medical University. We analysed clinical background of mothers and prognosis of neonates. The objective of this study was to upgrade our perinatal care tailored to regional demand. The following results were obtained. 1) Maternal transport was necessary in 90.7% of the mothers. Preterm Premature Rupture of the Membranes (PPROM) was present in 38.8% of them. 2) The percentage of mothers with a cervical dilatation of more than 4cm was significantly higher in mothers without PPROM than in those with PPROM. 3) Delivery occurred within 24 hours in 86.8% of mothers without PPROM who had a cervical dilatation of more than 4cm. 4) The percentage of cesarean sections was 16.5%. 5) Death in the neonatal period occurred in 10.8% of VLBWI, 20% of extremely low birth weight infants (ELBWI, <1,000g), and 42.8% of infants weighing less than 750g. 6) There was no significant difference in the incidence of intraventricular hemorrhage (IVH) between infants with cephalic presentation and infants with breech presentation, or between infants delivered vaginally and infants delivered by cesarean section. The incidence of IVH was significantly higher in infants weighing less than 1,000g than in those weighing 1,000g or more. 7) The neonatal death nate and the incidence of IVH were significantly higher in infants weighing less than 750g than in those weighing 1,000g or more. 8) The incidences of pneumonia and sepsis were significantly higher in infants with PPROM than those without PPROM. (9) In infants with PPROM, the incidences of respiratory distress syndrome and patent ductus arteriosus decreased as sepsis was prolonged, but the incidence of penumonia did not change markedly. These findings demonstrate that the birth of infants with an VLBWI should be prevented in order to ensure satifactory perinatal care.

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