Ibaraki Prefecture is noted for its high mortality rates among babies in the perinatal period. During 1984, 10. 9 of every 1, 000 perinatal babies died, compared with the national average of 8. 7. In the prefecture, however, there are considerably wide gaps in the survival odds of perinatal babies from region to region.
Statistics covering 92 cities, towns and villages in Ibaraki Prefecture showed that perinatal mortality rates during the period of 1979-83 stood at 13.4 on the average. The average of the top 10 municipalities on the deathrate list was 22.7, while that of the last 10 municipalities was 7.18. The municipalities marking higher rates are concentrated in the southeastern part (6regions) and western part (1 region) of the prefecture, and the municipalities marking lower rates are located in northern Ibaraki (6 places).
The reason for this uneven distribution remains to be seen. However, we have investigated into the situations of these municipalities in terms of the size of population, live birth rate, fatal mortality rate, infant mortality rate, neonatal mortality rate and early neonatal deaths. Furthermore, a survey was carried out on the number of deliveries in hospitals and weight of newborns in the northern, southeastern and southern/central parts of the prefecture.
It was found that only three medical institutions have NICU (intensive care unitfor neonates) across the prefecture. This number is rather small considering the number of beds. This may be partly responsible for the high rate of perinatal mortality rate in Ibaraki Prefecture. The rate in our hospital, wich is located in the southern part of the prefecture, has dropped from 19.8 to 9.7 since a NICU was installed.
The present paper will also discuss other findings in the high perinatal mortality rate regions in southeastern Ibaraki Prefecture.

We retrospectively studied the physical and neurological prognoses of 51 small-for-date infants (SFD) who had been taken care in our faculty during the neonatal period. The values of physical measurements of SFD at one and two years of age were both significantly smaller than those of the controlled appropriate-for-date infants. Majority of infants with symmetrical intrauterine growth retardation, whose head circumferences at birth were under -1.5 S. D., showed many complications during the neonatal period, for example; hypoglycemia and polycytemia, and their neurological prognoses were poorer than those with asymmetrical intrauterine growth retardation. To improve these grave prognoses, we stressed the necessity of the system which can provide strict maternal and neonatal care as well as the continuous observation even during the grownup under the co-operation of obstetrician and pediatrician.

Between 1987 and 1990, Tsuchiura Kyodo Hospital treated a total of 153 cases of squamous cell carcinoma of the uterine cervix after establishing definitive diagnosis. Of the total, 46 cases in stage 0, 43 cases in stage Ia and 21 cases in stage Ib were studied retrospectively in order to investigate the sensitivity of cytological and histological tests and the rate of agreement between cancer diagnoses made by the two departments. As a result, it was confirmed anew that there is much to be done to improve the diagnostic accuracy, which is vital to the success of the treatment for early cancer of the uterine cervix.
A summary of the findings is as follows:
The cytological examination data showed that the positive results were obtained in 69.6% of the cases in stage 0, 67.4% in stage Ia and 84.2% in stage Ib. The corresponding percentages in the histological examination were 50%, 67.5% and 89.5% respectively. The argreement rations were as low as 30% in stage 0, 53.8% in stage Ia and 84.2% in stage Ib.
Similar study was made on 43 cases of conization which is regarded as a useful means of detecting cervic cancer, The ratio of detection of early cervic cancer was 29.4% before conization. After conization, the ratio jumped to 74.4%.
The present level of diagnostic accuracy is such that the routine conization procedure is indispensable. For the treatment of cervical cancer in stage 0, it is advisable to perform hysterectomy. For the stage Ia cancer, semi-radical hysterectomy should be indicated. Lymph-node clearing is not always required.
In stage 0, diagnostic conization should be followed by treatmental conization or by removal of the remaing part of the uterus after making sure that the conization procedure was appropriate and taking into consideration the patients' age and fertility. In light of the present level of medical technology, however, hysterectomy may be the first to be considered.