[automatically translated] Introduction: Pregnancy, childbirth and the postnatal period are physiological events that can sometimes get complicated so unpredictable and serious consequences for the woman, the unborn and the neonate. National standards provide for the progressive rationalization / reduction in birth centers with number of shares less than 1000 / year, and the combination for the same complexity of the activities of UU.OO. obstetrical and gynecological with those neonatology / pediatric, bringing back two of the previous three levels of care. The birth points without a guard cover medical-obstetric, anesthetic and active pediatric doctor 24 h, or human resources and adequate equipment should take charge at risk births. The transfer of the child shortly after birth, in the presence of risk predictors conditions for the newborn at birth, it is a poor indicator of the clinical pathway management. Objectives: To evaluate the appropriateness of the path of birth and care management of phases in the early hours of birth with reference to the "at-risk infants." Methods: As a case study analyzes the data obtained from the Birth Certificate Assistance (Cedap) and from hospital discharge records (SDO). It 'was then conducted a descriptive analysis of the volumes of births at risk and moved within three days of birth for structural complexity. The definition of risk newborn is determined on the basis of certain criteria, based on gestational age, birth weight, SGA (Small for Gestational Age) age of the mother and pregnancy multiline, with the risk values defined from 0 to 3 (no risk factor among those selected, a factor, two factors, more than two). By linkage deterministic and probabilistic record processes between data drawn from a source Cedap and SDO, they analyze some aspects of the newborn at risk management in terms of transfers between types of hospitals, especially in light of the recent regional legislation. Results: In 2013, the Region of Sicily were observed 8,871 (20.3%) share of infants with at least one risk factor among those selected. The percentage of linkage between Cedap and at least one of the two SDO (mother and child) was equal to 97.2%. Of 8,324 infants at risk linked with the SDO flow, as many as 34, 6% were even assisted in a birth point no Level II. The percentage of births handled in centers II level increases as the level of risk, with values of 75% for infants with two risk factors and 78% for infants with at least three risk factors. With regard to transfers within three days of birth, of 568 transfers, 14.9% were transferred from birth centers II level, and 73.9% from level I facilities, while 11% of transfers has affected other structures. Conclusions: The analysis allows to evaluate the appropriateness of the birth path through some indicators concerning the management of infants at risk within the regional service network.
|Number of pages||1|
|Publication status||Published - 2015|