The causes of perinatal mortality in Bulawayo, Zimbabwe
Aiken, C.G.
Central African Journal of Medicine 38(7): 263-281
1992
ISSN/ISBN: 0008-9176 PMID: 1477875 Document Number: 398523
The causes of all perinatal deaths at Mpilo Maternity Hospital were investigated over a 12-month period, during which there were a total of 466 stillbirths and 379 neonatal deaths, with a perinatal mortality rate of 36.0/1000 births in Bulawayo, Zimbabawe. The causes of death were in order of importance; congenital syphilis (20.5 pc), birth asphyxia (18.8 pc), unexplained stillbirths (11.8 pc), hyaline membrane disease (11.5 pc) neonatal septicaemic (10.8 pc), congenital malformations (7.7 pc), pregnancy induced hypertension (5.4 pc), placental abruption (4.9 pc), congenital infection (2.2 pc) and other causes (6.4 pc). Eleven pc of mothers booking in antenatal clinics had positive syphilis serology. Most were successfully treated. But over 400 mothers with early syphilis escaped treatment usually because they booked late or failed to book at all at antenatal clinics (74 pc) and occassionally because they had false negative results or were infected after early booking (27 pc). They delivered 101 stillbirths, most of whom died prematurely before labor and often had abdominal distension. There were 72 neonatal deaths, most of whom were preterm babies with respiratory distress and ofter hepatosplenomegaly. One half of the deaths from asphyxia were caused by prolonged obstructed labor and one quarter by prolapsed cord, struck head in breech delivery and retained second twin. The incidence of both early and late onset neonatal septicaemia was very high with Group B Streptococci, Klebsiella and Staphylococcus aureus the predominant pathogens. Improved antenatal, intrapartum and neonatal care could substantially reduce the perinatal mortality rate by preventing congenital syphilis and birht asphyxia and by treating hyaline membrane disease and neonatal septicaemia.