An Analysis of Causes and Avoidable Factors of Perinatal Deaths at Tertiary Care Hospital (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.
Perinatal mortality in tertiary care institution-A prospective study
2017
Objective: The objective of this study was to determine perinatal mortality rate and to identify various factors influencing it. Material and Methods: A descriptive observational study was done in a tertiary care institution of state for a period of one year. Results: There were 3760 births, 233 perinatal deaths with perinatal mortality rate of 63.64/1000 live births. The major causes of perinatal deaths were prematurity, low birth weight and septicemia of baby. Conclusion: Improving perinatal mortality is the need of the hour. Prematurity, low birth weight, septicemia and maternal hypertensive disorders were the leading causes of perinatal deaths. These deaths can be reduced by increased awareness and vigilance during antenatal period.
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.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018
Background: This study helps to assess the burden of perinatal mortality at a tertiary referral hospital in Sikkim known for its hilly terrain which makes health services difficult to access. The aims and objectives were to determine the various causes and risk factors leading to perinatal mortality in order to formulate preventive strategiesMethods: All perinatal deaths over a year between August 2016-2017 were included and analysed in our study.Results: A stillbirth rate of 14 per 1000 total births and early neonatal death rate of 8 per 1000 live births was found in 1855 total births. Complications related to pregnancy like pre-eclampsia (16%), eclampsia (8%), ante-partum haemorrhage (15%) and medical disorders (13%) were major contributors to stillbirths while pre-maturity (53.3%), sepsis (20%), birth asphyxia due to meconium aspiration (13.3%) were notable factors leading to early neonatal deaths. In majority of the cases, factors like poor literacy, low socio-economic status, i...
Prematurity: A Major Cause of Early Neonatal Mortality in Ad-din Medical College Hospital
Bangladesh Journal of Medical Science, 2019
Objective: Early neonatal mortality within the fi rst 24 hours contributes substantially to overall neonatal mortality rates. Reliable cause- specific mortality data are limited; thus the estimated proportion of prematurity-related deaths nationally remains questionable. The objective was to determine the presumed causes of neonatal death within the fi rst 24 hours in Ad-din Medical College Hospital. Methods: This is a retrospective study initiated in January of 2016 to December 2016, conducted in the delivery room and adjacent neonatal area at Ad-din Medical College Hospital. Research assistants were trained to observe and record events related to labor, neonatal resuscitation, and 24-hour postnatal course. Perinatal asphyxia (PNA) was defined as failure to initiate spontaneous respirations and/or 5-minute Apgar score <7, prematurity as gestational age <37 weeks, and low birth weight (LBW) as birth weight (BW) < 2500gm. Data were analyzed with using the SPSS version (Chi-Squ...
Study of obstetric factors in perinatal morbidity and mortality at a tertiary centre
International journal of reproduction, contraception, obstetrics and gynecology, 2017
Background: Safe motherhood and child survival have always been a concern for the policymakers but perinatal mortality, especially stillbirths, have not received due attention. There are 5.9 million perinatal deaths worldwide, almost all of which occur in developing countries. Stillbirths account for over half of all perinatal deaths. This study was aimed to determine perinatal mortality rate and related obstetrics risk factors. Perinatal mortality is only a tip of the iceberg, morbidity being much higher. Vital statistics obtained through this study may serve an important source of information to guide the public health policy makers and health care providers in future. Methods: Present observational study was undertaken in a tertiary center to look into various maternal factors and possible cause of perinatal death. All perinatal deaths including stillbirths (SBs) and early neonatal deaths (ENNDs) within 0-7 days of birth after 28 weeks of gestation were analysed. The data was collected through a pre-designed proforma. Results: Perinatal mortality is 66.27/1000 births in our centre, where 37% were intrauterine deaths, 34% were neonatal deaths and 29% were still births. Preterm, pregnancy induced hypertension; abruptio placentae remain the most important factors for perinatal loss. Conclusions: One of the reasons for high perinatal mortality in tertiary centres is because of poor antenatal care at peripheral centres and late referrals. Early detection of obstetric complications and aggressive treatment is one of golden rule to reduce perinatal loss.
Journal of midwifery and reproductive health, 2021
Background & aim: Perinatal mortality is used in international scales as a reflection of the quality of maternal and newborn care. Therefore, the current study aimed to determine perinatal mortality and its associated factors at Besat Hospital of Sanandaj within 2013 to 2015. Methods: This retrospective case-control study was conducted using medical records available at Sanandaj Besat Hospital during 2013- 2015. Sampling was conducted through the census method. Firstly, all cases of perinatal mortalities in the delivery and neonatal wards whose medical files were complete (n=466) were selected as the case group, and a file of live birth for each case was randomly chosen on the same day as the control (n=466). Data analysis was performed by SPSS 21 using the Chi-square, independent samples t-test, and logistic regression. Results: The rate of perinatal mortality was reported as 38.3 per 1,000 births. Parental consanguinity, parity, number of abortions, birth weight, gestational age, ...
Preventable causes and associated factors of neonatal death in Kota Bharu district
2016
Background of study: The Millennium Developmental Goal (MDG) target to reduce the under-five death rate by two-thirds from 1990 to 2015 was not achieved. Malaysia is expected to reduce the under-five death rate by year 2020. Neonatal death was an important contributor to the delay in reduction of overall under-five death rate. Objective: The aim of the study was to study preventable causes and associated factors of neonatal death in Kota Bharu district from January 2013 to September 2015. Methodology: A case control study was conducted between January 2016 till May 2016 involving health clinics in Kota Bharu district. Cases were babies who died during neonatal period and controls were babies who survived beyond the neonatal period. The study used secondary data derived from ‘stillbirth and under five mortality form’ and KIB 101 registration book as the source of data. The descriptive, simple logistic regression and multiple logistic regression analysis were applied to answer the obj...
Study of Maternal Mortality in a Tertiary Care Hospital, KGH
Background: Maternal mortality is the death of a woman while pregnant or within 42 days of termination of pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from the accidental or incidental causes. Maternal mortality is a key indicator of health services provided to population and reflects the health status of community. Methodology: This is a retrospective study of maternal deaths that occurred in King George Hospital, Visakhapatnam over a period of 1year (January 2019 to December 2019). Data is analysed using case sheets. Various causes of maternal deaths in this teaching hospital are identified. Results: In the study period there were 7568 deliveries and 69 maternal deaths. The direct causes accounted for 45 with hypertensive disorders, haemorrhage, sepsis as leading causes of maternal mortality. The indirect causes accounted for 24 with dengue fever, anaemia, heart disease and jaundice as leading causes of maternal mortality. Conclusion: Health education, regular antenatal checkups, early recognition of high risk cases, timely intervention, early referral, better transportation services in remote and tribal areas are needed to reduce maternal mortality.
A Retrospective Study of Maternal Mortality in a Tertiary Care Hospital
Background: Maternal mortality in developing countries is twenty times greater than that of developed countries according to WHO. It is a strong indicator for measuring the women health care. Most of the maternal deaths are preventable with prompt medical care. Aim: To study the factors causing maternal mortality in a tertiary care teaching hospital for four years period from 2016 January to 2019 December. Methodology: The present study is a retrospective hospital based study done in a tertiary care teaching hospital King George Hospital in Andhra Pradesh, a state in southern India. King George hospital is multidisciplinary teaching hospital serves about 9,000 to 10,000 pregnant women annually with majority of high risk pregnancies. The data is collected from the hospital medical records. The study included all maternal deaths of delivered and undelivered, miscarriages, MTPs, Ectopic pregnancy and also medical disorders complicating pregnancy. Exclusion criteria include the cases of brought dead mothers, maternal deaths due to accidents and suicides. Results: The total number of maternal deaths are 160 in a period of four years. Majority of maternal deaths are unbooked (87.5%). Only 12.5% maternal deaths were booked. 56.5% of the maternal deaths occurred in the age group of 21 to 25 years. Majority (57.5%) of maternal deaths occurred in multigravida. Antenatal deaths constituted 32.5% of total maternal deaths. 54.9% were post natal deaths. 13.75% of maternal deaths due to illegal MTP outside the hospital and ruptured ectopic pregnancy. 57% of the maternal deaths were seen in first 48 hours of delivery. 34.8% of maternal deaths were between 2 to 7 days of delivery. 32.5% of maternal deaths occurred within 24 hrs of admission. Out of 160 maternal deaths, 120 (75%) deaths are due to direct causes. Remaining 40 (25%) maternal deaths contributed for Indirect Obstetric causes. Of all the direct obstetric causes haemorrhage both antepartum and post-partum haemorrhage which accounts for 27% of the maternal deaths, 23% accounted for Preeclampsia and Eclampsia and another 23% from sepsis. Heart disease, anaemia, dengue fever, viral hepatits, pulmonary embolism were the indirect obstetric causes of death. Conclusion: Most of the maternal deaths are due to unidentified high risk pregnancies and delayed referral to the higher centers. Health services need to be upgraded at all the levels of health care centers. The triad of haemorrhage, hypertension and sepsis are still occupying the important obstetric causes of death. Obstetric haemorrhage is still one of major causes of deaths indicates the need for blood transfusion facilities even at first referral unit. Early detection and referring the high risk antenatal women to tertiary care centers is to be encouraged.