ABSTRACT
The study presents an overview of the changes in perinatal mortality rates at the Statewide Perinatal Center of New Jersey during the past decades. According to the data, the increase in the rate of cesarean sections from 4.5 percent to 17 percent, and the comparable reduction of the rates of manipulative intrapartum and extraction procedures, contributed significantly to the decrease of the perinatal mortality rates from 51/1000 to 17/1000 between 1971 and 1983. Of the new technical tools, those utilized for the evaluation of fetal well-being antepartum appeared to be more useful then those used intrapartum. On account of the high prevalence of genital infections in the population, the recent acceptance in the service of the use of invasive intrapartum technology, appears to have impacted unfavorably upon the perinatal mortality trends. The increased rate of births of premature babies, the widespread abuse of habit forming drugs in the community, and the routine use of procedures requiring artificial rupture of the membranes, probably all contributed to the rapid increase of the perinatal mortality rate in the Center from 15/1000 in 1986 to 28/1000 in 1988. It is concluded that perinatal care is a complex medical and social task. The overall result of the relevant efforts depends to a great extent upon the social environment, and the moral standing, educational level and motivation of the recipients.
Subject(s)
Infant Mortality , Humans , Infant, Newborn , New Jersey , Obstetrics and Gynecology Department, HospitalABSTRACT
Five newborns are presented who had meningitis and developed aqueductal stenosis. The diagnosis of obstruction was made by ventriculography during the course of meningitis. A variety of therapeutic measures (use of intraventricular antibiotics, use of reliably diffusible antibiotics, drainage of ventricles) led to varying results. Protocols should be established to assess each modality or combination thereof to help reduce the extremely high morbidity and mortality of this disease.
