A retrospective analysis of the risk factors leading to perinatal mortality at a tertiary care hospital of Sikkim, India (original) (raw)
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Journal of South Asian Federation of Obstetrics and Gynaecology
Aim: To analyze the perinatal mortality rate in a tertiary care center. Background: To identify possibly responsible maternal risk factors in a tertiary care hospital in developing country. Methodology: Data of perinatal deaths from 1 January 2019 to 31 December 2019 was collected from monthly perinatal mortality records. All patients with fetal death after 28 weeks of pregnancy till the period of 7 days after neonatal birth were included in this study. Results: The study conducted at our hospital aimed at investigating the causes of perinatal mortality and related maternal risk factors resulting in perinatal mortality. The total confinement number was 6,688; among these, the number of fresh stillbirth was 155, macerated stillbirth was 137, and neonatal death was 24. Among the 316 perinatal deaths, 241 deaths (69.6%) were noted before 37 weeks of pregnancy and 75 deaths were noted after 37 weeks of pregnancy (15.18%). Out of 316 deaths, 100 deaths observed in patients induced for labor. Of these, 100 neonates, 88 delivered vaginally and 12 neonates delivered by cesarean section. The 69 neonates (21.83%) deaths observed in the patients who had undergone cesarean section. A total of 33 (10.44%) deaths resulted due to birth asphyxia, 72 (22.78%) deaths observed due to preterm delivery, 22 (6.96%) deaths were due to congenital anomalies. Preterm was one of the most important risk factors observed in 72 (22.78%) women with perinatal deaths. Conclusion: Prematurity, low birth weight (LBW), no proper wrapping of newborns, and no guidance and proper training to mothers were significantly associated with higher probability of neonatal mortality.
2015
Introduction: Pregnancy, although being considered a physiological state, carries the risk of serious maternal morbidity and at times death. This is due to various complications that may occur during pregnancy, labor or thereafter. Maternal death has serious implications for the family, the society, and the nation. Maternal mortality is universally considered as human development indicator in a country and determines the health status of the people. Method: A retrospective hospital-based study of 65 maternal deaths was conducted over a period of 1-year from January 2014 to December 2014 in respect to maternal age, parity, booking status, residence, referral, socioeconomic class, admission death interval, and cause of death. Result: Over the study period, there were 6277 deliveries, 5761 live births, giving a maternal mortality ratio of 1035 per 100,000 live births. Eclampsia was the leading direct cause and anemia the leading indirect cause. The age group of 20 to 30 years was cruci...
Trends and Determinants of Perinatal Mortality in a Tertiary Care Hospital of Nepal
2021
Introduction: Perinatal mortality rate (PMR) in Nepal is still very high. In major hospitals of Nepal, it is still ranging from 20 to 30 per thousand births. This study was carried out to review the different aspects of PMR and classifying them and identify the causes of perinatal and neonatal deaths and assessing the need for improvement in quality of pregnancy and newborn care. Methods: It was a retrospective study carried out in Bharatpur Hospital, Chitawan, Nepal. Data of all stillbirths from 22 weeks of pregnancy and neonatal deaths up to seven days of life was taken from monthly perinatal audit and annual mortality review. The data was taken from July 2017 to Jun 2019. All the perinatal deaths were then classified. Results: Over a two year period, there were total 25,977 births and total death was 369. Thus perinatal mortality rate was 12.3 per thousand births. Still births (fresh and macerated) contributed almost 82.4% of the perinatal deaths and neonatal death contributed 17...
Risk factors for perinatal mortality in India: a systematic review of observational studies
International Journal Of Community Medicine And Public Health, 2022
Perinatal mortality (PM) is a major public health problem in India and multiple maternal and foetal risk factors have been attributed to high perinatal mortality. This review aimed to systematically summarize the epidemiological literature on maternal and fetal risk factors for PM including those for still birth, intrauterine deaths; early neonatal mortality; early neonatal deaths in India. This systematic review was compliant with preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. We searched for peer-reviewed articles from three electronic bibliographic databases: MEDLINE, Embase, Google Scholar published between 1 January 2000 and 31 March 2019 that reported the risk factors of perinatal mortality in India. Observational studies (cross sectional, casecontrol and COHORT Studies). Eighteen articles were included in this review. The major risk factors identified for perinatal mortality in India were maternal age, parity, higher birth order and maternal anemia. Complications during pregnancy like ante partum hemorrhage, preeclampsia, obstructed labor, preterm labor and fetal factors like gestational age and low birth weight were documented as risk factors for perinatal deaths. Strengthening national health programs and targeted interventions for both antenatal and institutional care is required to bring down perinatal deaths in India.
Perinatal mortality trend and classification of causes at a tertiary care centre of western Nepal
Journal of Kathmandu Medical College
Background: Identifying causes of perinatal death is important to reduce perinatal mortality rate. Objectives: To determine trend of perinatal mortality rate (PMR), ascertain causes, and find out changes in causes of death over period of seven years. Methods: This retrospective study, conducted after ethical approval, included stillbirths and early neonatal deaths at Manipal teaching hospital from April 2014 to April 2021, after 28 weeks of gestation or of foetuses weighing more than 1000 grams. Perinatal mortality rate of each year was calculated. Cause of death was assigned according to International Classification of Disease – Perinatal Mortality classification. Data analysis was done to find out trends and causes of perinatal mortality using SPSS v.21. Frequency and percentages were used to calculate causes of deaths. Results: Perinatal mortality rate decreased from 35.5 to 21.1 per 1000 births over seven years. Antepartum hypoxia (103, 45%) was commonest cause of antepartum dea...
Perinatal Mortality and Related Obstetric Risk Factors at a Tertiary Care Hospital of Hyderabad
2008
OBJECTIVE: To determine perinatal mortality rate and its related obstetric risk factors in our setup. DESIGN: Observational study. SETTING: Department of Obstetrics and Gynaecology (Unit-I), Liaquat University Hospital Hyderabad, from January to December 2006. PATIENTS AND METHODS: All perinatal deaths including stillbirths (SBs) and early neonatal deaths (ENNDs) within 0-7 days of birth after 24 weeks of gestation were studied during the study period, while Pregnancies <24 weeks of gestation were excluded from the study. The relevant information was collected through a pre-designed proforma which contained variables including maternal demographics, obstetric risk factors and other details. RESULTS: A total number of 2224 deliveries were analysed for perinatal mortality. Out of these, there were 224 perinatal deaths giving a PNMR of 100.7/1000 births. There were 196 SBs and 28 ENNDs. Among these, 88% women were unbooked. Commonest risk factors was antepartum haemorrhage (27.67%), followed by hypertensive disorders of pregnancy (23.21%) and mechanical factors affecting labour (14.28%). Congenital abnormalities were found in 9.8% of PNDs while maternal medical disorders were seen in 6.25% cases. In 3.5% cases, chorioamnionitis/ neonatal septicaemia was the underlying cause and multiple pregnancies were seen in only 02 (0.89%) cases. However, in 32 (14.28%) cases, no cause was found. CONCLUSION: The high perinatal mortality rate in present study is comparable to the figures from other institutions. Main reason being lack of antenatal and pre-pregnancy care where from almost all obstetric risk factors can be picked up and treated / prevented.
A Study on Perinatal Mortalities and Its Determinants at a Tertiary Hospital in a Metropolitan City
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH, 2020
The aim of the study is to estimate the perinatal mortality rate and its determinants. A retrospective observational study was conducted at a tertiary hospital in Maharashtra, India of the perinatal mortalities born from January 2017 to December 2017 after Ethics Committee approval. Data was acquired from the Delivery register of the Labour room covering the maternal socio-demographic characteristics and the relevant investigations. The causes of perinatal mortality were simplified as per the Tulip Classification (2006). Statistical Analysis: The standard WHO formula for calculating the perinatal mortality rate was applied. Chi-square test followed by P-value were obtained through the Open Epi software, was used for estimating the statistically significant observations amongst the study results. The total births in the study period were 3461 and the perinatal deaths were 132. The Perinatal Mortality Rate computed to 39.65 per 1000 live births. Out of the 132 perinatal deaths, stillbirths were 89 and early neonatal deaths were 43.The perinatal mortalities were found to be highest in the age group of 30-35 years, multigravidae, unbooked and high risk obstetric patients and low birth weight newborns. Lack of antenatal registrations, unoptimised high risk pregnancies entering labour can potentially pose a threat to the delivery outcome.
A study on maternal mortality in a tertiary care center in South India
IP innovative publication pvt. ltd, 2019
Introduction: Maternal mortality has long been considered as a very good indicator for healthcare quality provided. Pregnancy is considered to be a physiological phase in the lifetime of a woman carrying serious implications on morbidity and mortality. It has been agreed upon that many of the maternal deaths in developing countries can be prevented. Aim: To study the prevalence of maternal mortality between March 2014-March 2018 in our hospital. Methods and Materials: It’s a retrospective observational study done at a tertiary care centre in southern part of India. Maternal deaths from March 2014 to March 2018 were looked into. Maternal mortality ratio and causes for the maternal deaths were analyzed and compared. Demographic details were collected and data regarding parity, mode of delivery, gestational age at delivery, antenatal check-ups, co morbid conditions, causes of death were noted and neonatal outcomes were noted. Results: Overall live births in the period between March 2014-March 2018 were 18978, of which the number of LSCS were 9590(50.5%), the number of vaginal deliveries were 9388(49.5%), the number of maternal deaths were 39(MMR-205/100000 live births).The leading cause was sepsis 48.6% followed by postpartum hemorrhage (20%). The most common indirect cause was anemia (42.85%). Conclusion: Sepsis & hemorrhage emerged as the greatest killers. Many of the reasons of maternal mortality were found to be preventable. Early identification and stratification of risks with prompt initiation of necessary management measures are necessary to prevent these deaths.