[Perinatology in the Czech Republic at the end of the millenium. II. Intrauterine fetal transportation].

OBJECTIVE:To evaluate contribution of organizational changes in perinatal care among newborns below 1500 grams in Czech Republic in 1990-2000 and international comparison of results. DESIGN:Retrospective analysis of selected indicators of perinatal care. SETTING:Institute for the care of Mother and Child, Prague. METHODS:Analysis of selected national data and their comparison to international data from EAPM project "Perinatal Transport in European Countries". RESULTS:Due to findings that birth-weight specific early neonatal mortality is substantially lower among newborns transported in utero to perinatal centres than among newborns transported after birth, the organization of perinatal transport of pregnant women with preterm delivery was main task for system of perinatal care. The network of perinatal centers and organization of transport "in utero" led to high percentage of newborns below 1500 grams treated in specialized centres, even compared to other countries. However, according to number of treated patients in one centre per year the Czech Republic belongs among countries with small centres. CONCLUSION:Organizational measures in system of perinatal care led to high percentage of newborns below 1500 grams treated in perinatal centres. This concentration contributed together with improved clinical perinatal care to important decrease of total perinatal mortality to 4.4@1000 in the Czech Republic in 2000. According to number of treated newborns with birth-weight 1500 grams and more there are too many perinatal centers of intermediary care in the Czech Republic.