Recent Progress in Perinatal Medicine II. [antikvár]

In recent years infant mortality rates were significantly reduced, mainly in consequence of the reduction of late infant mortality. Similarly good results were achieved in the field of maternal mortality. Despite of these results, the perinatal mortality has not been decreasing in the expected degree during the last two decades, and it's rate is still 23% in our country. The significant factors affecting neonatal mortality are wellknown: — the course of pregnancy — the gestational age and birthweight of the newborn — the course and the management of labor and the primary neonatal care (in the delivery room). These factors raise a lot of medical and organizational questions, and require answers and solutions. Although it is impossible to undertake the task of a comprehensive analysis of each components of the question in this limited space, let me have the privilege to emphasize a few ideas. The estimation of fetal condition (above all in the pre-and subnatal period) is regarded as the fundament of modern obstetrics and neonatology. Our aim is to achieve the earliest possible diagnosis of the intrauterine risk, the possible most exact estimation of the degree of this risk, and to take immediate steps to avert, even to prevent it with the aid of intrauterine therapy. The prenatal diagnostics is making efforts to grow up to its task and has already achieved significant results. The effective use of the important parameters of the fetus, the fetoplacental unite, the placenta and the amniotic fluid is increasing. Basic problem, that these parameters had became the instruments of modem obstetrics by empiria, and for that reason the information they contain are mainly summarized data, and are apt to conceal the concrete problems. Direct consequence of all this, that to improve the results of perinatology further, one has to set out — beside the line of previous studies — into new directions of investigation with the help of modern physiology, pediatrics, neonatology, obstetrics and social sciences. It is wellknown, that in our country one of the main contributors to perinatal mortality is the high percentage of prematurity. The premature birth is a complex phenomenon in itself. Several factors — maternal, fetal and environmental - are playing important parts in the birth of the underweight newborn. One of the most important mission of the perinatal medicine is to study the several factors leeding to premature birth, and if the preventive measures fail, it's task is the care of the prematures on a high level, for the sake of the tendentious reduction of postnatal loss. The aim