[The role of maternal care in reducing perinatal and neonatal mortality in developing countries]. / Rolul îngrijirilor materne în reducerea mortalitatii perinatale si neonatale în tarile în curs de dezvoltare.

PIP: Neonatal and perinatal mortality is directly linked to the health of the mother immediately after birth. Numerous international scientific meetings among them the 45th session of the Mixed Committee of WHO in January 1985, have dealt with this issue. Maternal mortality is defined as the death of the mother 42 days after delivery. Perinatal mortality includes delayed fetal death and early neonatal death. Delayed fetal death often occurs in newborns weighing under 1000 gm. Usually perinatal mortality is defined as the number of delayed fetal deaths and early neonatal deaths among those weighing over 1000 gm/1000 live births. The neonatal mortality level corresponds to the number of deaths of children born alive at 4 weeks/1000 live births. Postnatal mortality means the death of children born live up to 1 year of age. Infant death means death under age 1. Infant mortality level is defined as deaths of infants that survive for a whole year. The major problems of infant health include diarrheal diseases normally requiring vaccination and malnutrition during the first month of life. In Bangladesh, Lesotho, and Mexico, the mortality level ranges between 32.8 to 135/1000 live births. Neonatal mortality makes u 42-63% of infant mortality. The perinatal period comprises the period between 28th week of pregnancy and the 7th day of life. Diarrhea and respiratory infections contribute to perinatal mortality. In developing countries, maternal mortality related to pregnancy of women aged 15-45 occurs most often. 2-10 maternal deaths/1000 live births to as high as 20/1000 are current estimates. In Nigeria, among adolescents, the rate is 50-70 deaths/1000 live births. 124 perinatal deaths that occurred in 1970 and 1973 in India were analyzed yielding these percentages: insufficient birth weight 32%, asphyxia 19%, obstetrical trauma 18%, congenital anomalies 7%, tetanus of the newborn 3%, and others 21%. In Africa and Southeast Asia tetanus-related neonatal mortality amounts to 10-30/1000 live births and the total annual toll reaches 750,000 to 1 million globally mostly because of nonsterile instruments. 90% of tetanus incidence in Romania was eradicated by vaccination. Preventive measures can reduce mortality: education of women on health and hygiene, avoidance of heavy labor during pregnancy, family planning services, aseptic techniques, vaccination against tetanus and other infectious diseases, chemical prophylaxis against malaria, improved obstetrical care, consolidated support system, and community participation.^ieng

Evaluation of the prematurity risk on the ground of severity scores reflecting the action of different factors, maternal virus infection included.

A mathematical methodology is suggested which allows the a priori calculation of the risk of premature delivery, by a formula relying on the scores attributed to different specific risk factors (maternal virus infections included). The scores are estimated either directly, or starting from the scores of nonspecific factors. The statistical significance of the different scores, correlations and formulas is analyzed.

Statistical studies on the epidemiology of human congenital malformations. Implications of maternal virus infections.

Prospective and retrospective statistical studies were performed in 1,000 cases of congenital malformations. The incidences and severity of the different types of malformations were correlated with the risk and protection factors having acted on the pregnant woman. The correlation coefficients were higher in the case of specific risk factors, among which special attention was paid to maternal virus infections. The possibility is discussed of developing a programme for the individual protection of high-risk cases, implying the compensation of the exposure to risk factors by the application of adequate protection factors, according to the calculated scores.

Prevalence of mycoplasma in the genital tract of pregnant women. Preliminary data.

The prevalence of Myoplasma hominis and "T" strains was investigated in 175 pregnant women in the 12th--40th week of pregnancy. It was possible to isolate the "T" strain from 30.3%, M. hominis from 11.4% and both strains from 9.7% of the women.

[Long-term study of the effect of successive surveys on tuberculosis endemia]. / Studiu longitudinal al influentei depistarilor succesive asupra endemiei tuberculoase

A whole rural population of 16359 subjects was followed for a period of 24 years. This period of 24 years is well divided from the viewpoint of the succesive systematic detection three intervals being selected, as follows: a) the stage of usual anti-tuberculous assistance; b) the stage of scientific experimentation consisting in 3 radiophotographic detections repeated every two years and the annual control of groups with high risk, between 1960--1965, completed by integral biological detection in children (every year) and bacteriological controls. The population controls were followed by the diagnosis; c) the stage of discontinuing the experiment when current antituberculous assistance was resumed, between 1966 and 1974. All cases of active pulmonary tuberculosis, that have been recorded through all the methods of investigation over a period of 24 years in all these localities are correlated, on the one hand to one another, and on the other hand with objective documents obtained during the period of intensive control of the population over the 6-years interval. Thus the limits appear more correctly, within which this natural history of the disease can be detected through various types of population control, as well as some practical consequences for the improvement of the technique and of the control methodology in the future.

[Medical radiophotography in the activities of rural polyclinics]. / Radiofotografia medicala în activitatea policlinicii rurale

The county polyclinic provides the radiophotographic control of a rural population of 122.741 inhabitants from the area surrounding the capital city of Bucharest. Of the total number of cases of pulmonary tuberculoses that have been recorded only 16,6% were detected in the fixed center and 61,8% by integral detections, carried out by the radiophotographic caravans. That is why the authors consider that this is not the right time to abandon integral detection. The fixed centers, by performing examinations in all those entering new jobs detect cases of tuberculosis belonging to other geographical areas. Thus, of 235 cases detected over a period of 3 years, 67% belonged to other territories and only 33% were from the population normally covered by the center. This is the filter role played by fixed centers carrying out radiophotographic detection. As compared with the 235 cases of tuberculosis there were 399 cases of non-tuberculous pulmonary diseases.