Quality and Quantity of Obstetrical Care in Baross Street Department of Obstetrics and Gynecology between 1990 and 2006

Abstract

Introduction, aim and methods: Authors report data from 48,794 deliveries at 1st Department of Obstetrics and Gynecology, Semmelweis University, from January 1, 1990 to December 31, 2006. Data were analyzed based on their computer database, showing the complexity of obstetrics, genetic counseling and neonatology. Results: For an easy survey, data are shown on detailed figures. In the last 17 years the delivery number is increasing, from 2,299 in 1990 to 3,861 in 2006. Early neonatal mortality rate is decreasing (22 infant deaths per 1,000 live births in 1990 compared with 6 in 2006). If we do not take those < or = 1,000 grams or intrauterine death outside the institute or induction of labour because of malformation, perinatal mortality is very low, below 6/1,000 deliveries in the last 7 years, 2.8 in 2004, 1.8–1.9 in 2005 and 2006. Neonatal and infant mortality is also decreasing. There is an increase in the frequency of caesarean sections, 15–20% in 1990–1991, and approximately 35% in the last years. Main indications are previous caesarean section, threatened fetal hypoxia, dystocia, cephalopelvic disproportion, twin pregnancy, hypertension/praeeclampsia/HELLP syndrome, breech presentation. Conclusions: Because of the progressive system in obstetrics care in Hungary, in this leading institute approximately one fifth of the deliveries are preterm, furthermore they also have numerous severe pathological cases, though there are favorable changes in perinatal statistics in the last 17 years, showing the continuous improvement in obstetrical and neonatological care.