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  • Title: [Profile of health care in Latin America: perinatal services in Cuba].
    Author: Cabezas Cruz E.
    Journal: Rev Latinoam Perinatol; 1990; 10(2):57-63. PubMed ID: 12317013.
    Abstract:
    Perinatal care should not be limited to events surrounding delivery, but should extend to prenatal and puerperal care and even to preventive care before pregnancy so that the expected child can develop to its full genetic potential. Cuba's perinatal care program has been aided by the existence of the Prioritized Program for Maternal-Child Care, which aims to improve the survival and health of mothers and children through improved health care and other means. The perinatal care program incorporates priority care to high risk pregnancies, legal and social protection of maternity, health education and preventive care for the mother, full and informed access to family planning, and other aspects. Prenatal care is developed in 3 levels, with primary care available in both rural and urban areas and secondary level care at municipal and provincial hospitals. Cuba has 148 "maternity homes" with 2261 beds were pregnant women can receive outpatient care before delivery or can await the birth if they far from the hospital or lack transportation. At the tertiary level, specialized care is available if needed from specialized research institutions. The 1st consultation takes place in a polyclinic, rural hospital, medical post, or family physician's office. A complete clinical history and general physical examination are included. After 2 weeks, an evaluation is done in which a specialist determines where the woman will receive prenatal care. In every case the alpha fetoprotein level is determined between 15-19 weeks, an ultrasound is done at about 20 weeks, genetic studies are done if the mother is 35 or over, tetanus inoculation are given, and other services are provided. All pregnant women are reassessed between 28-32 weeks. Women possibly at high risk are evaluated prior to pregnancy and offered temporary or permanent contraceptive methods if necessary. Women and infants at elevated risk are monitored carefully in special perinatal care centers, which are eventually planned for all facilities with over 1500 births annually. Women are seen by a physician within 15 days of delivery and again about 45 days after delivery for postpartum care and a family planning consultation. All newborns are examined by a physician within 7 days of delivery. Virtually all deliveries in Cuba now occur health facilities, attended by qualified personnel.
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