AB898         10 YEARS OF OBSTETRICS ON THE FORMER ISLE OF URK: SOME KEY NOTES AND TRENDS

Author(s): 
Dekker CJ, Mungra A, Springer MP
Department of General Practice, Leiden University Medicine, Leiden University Medical Centre, URK, THE NETHERLANDS
Text: 
Objective:
To investigate to what extend obstetric care on the former isle of Urk, which is strictly provided by general practitioners (GPs), is comparable to obstetric care in the general population and to compare some keynotes and trends.
Methods: A retrospective analysis was performed of the data of women who gave birth in the period 1986-1995. The data was registered according to the national Dutch registration procedure (National Perinatal Database of the Netherlands), in which all obstetric data, including data from gynaecologists, midwives and GPs, are registered. Data was checked and completed by examining patient's files. Missing cases were traced through the local registry office.
Results: Women from Urk start having babies at an earlier age than the average population, and they go on having babies past the average age. The age at which they had their first child rose slowly in the decade under investigation: from 22 to 24 years of age, still 4 years below average. Only 25% of these women were primipara, whereas the national percentage of primipara is 40 to 50. Although the percentage is slowly diminishing (from 70 to57%), 64% of the women gave birth at home (national percentage 31). Thus, home deliveries took place twice as often on Urk compared to the rest of the Dutch population. A very low percentage of artificial deliveries was found on Urk: 3% Caesarean sections and 5% instrumental vaginal deliveries. The perinatal mortality rate (amenorrhoea more than 24 weeks) was 0,95%, the same as the national rate.
Conclusions:
General trends in obstetrics are also seen in the women on the former isle of Urk, in spite of their rather isolated way of life. A high percentage of home deliveries, few artificial deliveries and a percentage of perinatal mortality that is slightly below the average, seem to advocate primary obstetric care given by the general practitioner.