Clinico-pathological study of causes of perinatal mortality in a developing country
Naidu, S.; Moodley, J.; Adhikari, M.; Ramsaroop, R.; Morar, N.; Dunmoye, O.O.
Journal of Obstetrics and Gynaecology the Journal of the Institute of Obstetrics and Gynaecology 21(5): 443-447
2003
ISSN/ISBN: 0144-3615 PMID: 12521794 DOI: 10.1080/01443610120071956Document Number: 234154
The aim of this study was to identify clinical causative factors of perinatal deaths, supported by post mortem evidence where possible. This was a prospective descriptive study. The total number of deliveries and perinatal deaths over a 6-month period were recorded and clinicodemographical data was noted. Post mortem examination information, if available, was also recorded. There was a total of 7789 deliveries over the 6-month period and 460 perinatal deaths, giving a perinatal mortality rate of 59/1000 deliveries; 45% (n=207) of the perinatal deaths had post mortem examinations. The mean age was 26 years; 84.8% were single mothers. One-third of the group were unbooked: the mean gestational age of fetal death was 31 weeks, and the mean birth weight was 1700 g. Two-thirds of the perinatal deaths were stillbirths. The leading obstetric causes of deaths were: abruptio placentae (25.3%), hypertension in pregnancy (24.9%), prematurity (17.4%), unexplained stillbirth (13.4%) and intrapartum asphyxia (9.2%). The perinatal mortality rate of 59/1000 deliveries is high. Although this is comparable with other developing countries, there is a need for improvement in organization of obstetric and neonatal care, staffing levels and access to and effective utilization of antenatal services. These will probably lead to a significant reduction of this relatively high perinatal mortality rate.