Regionalization of perinatal care and in utero referrals

Further improvement in perinatal morbidity and mortality figures implies in utero referral so high risk infants, particularly very early maturity infants, can be managed immediately in specialized centers. The success of such referrals depends directly on the coherence of the regional perinatal health tare network. It has been demonstrated that the chances of survival and of sequelae-free survival are greater for very premature infants born in a center with a neonatal intensive care unit. The situation in France leaves room for improvement. Only 15% of the infants born before 33 months gestation and with birth weight under 1500g are born in level III maternity wards equipped with a neonatal intensive care unit The goal is 80%. We have tried to analyze the reasons behind this situation and propose ways to better organize perinatal health care.