Perinatal Mortality in Retrospect and Prospect

1969 ◽  
Vol 14 (3) ◽  
pp. 89-94
Author(s):  
J. Thomson
Keyword(s):  
Mortality Rate ◽  
Perinatal Mortality ◽  
No Reduction ◽  
Maternity Hospital ◽  
Early Years ◽  
National Data ◽  
Maternal Deaths ◽  
Neonatal Deaths ◽  
Marked Decline ◽  
The Subject

Little interest was displayed in perinatal mortality until the work of Ballantyne in the early years of this century. Scotland has had national figures available for causes of stillbirths since 1939 and also for neonatal deaths since 1958. The National Perinatal Mortality rate has dropped by 50 per cent since 1939 but the mortality rate for the first 24 hours of life has shown no improvement. Comparison of national data with figures from a maternity hospital shows a greatly increased number of deaths from unknown causes in the national data: it is suggested that the national data do not present a true picture due to inadequate certification. Study of the hospital figures over a period of 15 years shows little change in the total deaths, the marked decline in the number of stillbirths being balanced by a marked increase in first-day deaths. Difficult labour and birth injury are decreasing as causes of perinatal mortality. Deaths from malformations, toxaemia, placental haemorrhage and unknown causes show little or no reduction. It is suggested that perinatal deaths should be the subject of an inquiry such as that for maternal deaths. The changing pattern of perinatal mortality calls for constant reassessment.

scholarly journals The utility of delivery ward register data for determining the causes of perinatal mortality in one specialized and one general hospital in south Ethiopia

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Tesfalidet Beyene ◽  
Catherine Chojenta ◽  
Roger Smith ◽  
Deborah Loxton
Keyword(s):  
Birth Weight ◽  
Mortality Rate ◽  
Perinatal Mortality ◽  
Maternal Deaths ◽  
Apgar Scores ◽  
Neonatal Deaths ◽  
Factors Associated ◽  
South Ethiopia ◽  
Early Neonatal Mortality ◽  
Early Neonatal Deaths

Abstract Background Globally, the burden of perinatal mortality is high. Reliable measures of perinatal mortality are necessary for planning and assessing prenatal, obstetric, and newborn care services. However, accurate record-keeping is often a major challenge in low resource settings. In this study we aimed to assess the utility of delivery ward register data, captured at birth by healthcare providers, to determine causes of perinatal mortality in one specialized and one general hospital in south Ethiopia. Methods Three years (2014–2016) of delivery register for 13,236 births were reviewed from July 12 to September 29, 2018, in two selected hospitals in south Ethiopia. Data were collected using a structured pretested data extraction form. Descriptive statistics assessed early neonatal mortality rate, stillbirth rate, perinatal mortality rate and causes of neonatal deaths. Factors associated with early neonatal deaths and stillbirths were examined using logistic regression. The adjusted odds ratios with a 95% confidence interval were reported to show the strength of the association. Result The perinatal mortality ratio declined from 96.6 to 75.5 per 1000 births during the three-year study period. Early neonatal mortality and stillbirth rates were 29.3 per 1000 live births and 55.2 per 1000 total births, respectively. The leading causes of neonatal death were prematurity 47.5%, and asphyxia 20.7%. The cause of death for 15.6% of newborns was not recorded in the delivery registers. Similarly, the cause of neonatal morbidity was not recorded in 1.5% of the delivery registers. Treatment given for 94.5% of neonates were blank in the delivery registers, so it is unknown if the neonates received treatment or not. Factors associated with increased early neonatal deaths were maternal deaths and complications, vaginal births, APGAR scores less than 7 at five minutes and low birth weight (2500 g). Maternal deaths and complications and vaginal births were associated with increased stillbirths. Conclusion Our findings show that an opportunity exists to identify perinatal death and newborn outcomes from the delivery ward registers, but some important neonatal outcomes were not recorded/missing. Efforts towards improving the medical record systems are needed. Furthermore, there is a need to improve maternal health during pregnancy and birth, especially neonatal care for those neonates who experienced low APGAR scores and birth weight to reduce the prevalence of perinatal deaths.

Explanation of Perinatal Mortality Rate in Collaborative Study

PEDIATRICS ◽  
1973 ◽  
Vol 52 (6) ◽  
pp. 891-891
Author(s):  
Arnold S. Goldstein ◽  
Henry H. Mangurten
Keyword(s):  
Mortality Rate ◽  
Perinatal Mortality ◽  
Umbilical Artery ◽  
Collaborative Study ◽  
The United States ◽  
Mortality Rates ◽  
Single Umbilical Artery ◽  
Neonatal Deaths ◽  
General Mortality ◽  
Future Management

The article by Froehlich and Fujikura1 on the prognosis of single umbilical artery is a much needed and highly informative addition to the literature. It presents a great deal of information and some important implications as to future management. We question the mortality rates quoted. They are given as percentages, and include stillbirths and neonatal deaths, i.e., perinatal mortality. The figure given as the general mortality rate is 3.8% or 38 per 1,000 births. Previous figures cited for perinatal mortality in the United States have varied from approximately 19 per 1,000 to approximately 26 per 1,000.2-4 We wonder how the figure of 38 per 1,000 was determined.

scholarly journals Perinatal Mortality and Morbidity at Dr. Pirngadi Hospital Medan 1985-1986

2018 ◽  
Vol 29 (5-6) ◽  
pp. 97-104
Author(s):  
Guslihan D. Tjipta ◽  
Dachrul Aldy ◽  
Noersida Raid ◽  
Baren Ratur Sembiring
Keyword(s):  
Mortality Rate ◽  
Perinatal Mortality ◽  
Causes Of Death ◽  
Age Groups ◽  
Public Health Education ◽  
Hospital Quality ◽  
Mortality And Morbidity ◽  
Respiratory Problems ◽  
The Subject

A retrospective study was conducted on babies born during January 1985 to December 1986 at Dr. Pirngadi Hospital Medan. The aim of this study was to evaluate perinatal mortality and morbidity, and various possible factors related to the subject matter.The main results can be summarized as follows : There were 7102 deliveries during the study period consisting of 999 babies weighing less than 2500 gram and 6103 with body weight of 2500 gram or more. Perinatal mortality rate was 563.56 o/oo in the first group and 78.49 o/oo in the second while the avera/ mortality rate was 146.72 o/oo.Rate of perinatal demise was high in babies born from mothers in the age groups of below 20 and above 35 years, namely 681 .82 o/oo and 202.19 o/oo. It was also high among primiparae (165.67 o/oo) and more so among grandmultiparae (246.46 o/oo).There were 1966 (30.49%) ill newborn babies with asphyxia neonatorum accounting for 44.91%, infection 30.42% and respiratory problems 9.21% of the main causes of illness, while respiratory problems (40.05%) and injection (28.68%) constituted the main causes of death .We concluded that the rate of perinatal mortality and morbidity is still high at this hospital. Quality of prenatal and neonatal care with extensive public health education is necessary to be enhanced for the reduction of perinatal mortality and morbidity.

A Review of Caesarean Sections at 30 Weeks Gestation or Less in the West of Scotland 1988–1989

1992 ◽  
Vol 37 (2) ◽  
pp. 47-48 ◽  
Author(s):  
J. Dodgson ◽  
F. Mackenzie ◽  
C.A. Forrest
Keyword(s):  
Retrospective Study ◽  
Mortality Rate ◽  
Caesarean Section ◽  
Perinatal Mortality ◽  
Maternal Morbidity ◽  
Neonatal Period ◽  
Infant Survival ◽  
The West ◽  
Neonatal Deaths ◽  
Present Pregnancy

A retrospective study was carried out of caesarean sections at 30 completed weeks of gestation or less between 1/1/88 and 31/12/89 in Glasgow and The West of Scotland. One hundred and thirty-three caesarean sections were carried out resulting in 150 babies. Fifteen (11.3%) of these were classical sections. There were 30 neonatal deaths. The perinatal mortality rate was 170 per 1000. Survival was related to increasing gestation from 27 weeks onwards and also to birthweight from 900 grams onwards. In-utero transfers fared badly with seven out of 21 babies (33%) failing to survive beyond the neonatal period. Although survival continues to improve in newborns, the use of caesarean section should still be viewed with caution as the benefits in the very premature situation with regard to infant survival may be outweighed by the increased maternal morbidity both in the present pregnancy and future pregnancies.

scholarly journals KEMATIAN PERINATAL DI BLU RSU PROF. DR. R. D. KANDOU MANADO

2013 ◽  
Vol 1 (1) ◽  
Author(s):  
Mercy Tumundo ◽  
Hermie Tendean ◽  
Eddy Suparman
Keyword(s):  
Mortality Rate ◽  
Perinatal Mortality ◽  
Perinatal Death ◽  
Developed Countries ◽  
Perinatal Deaths ◽  
Neonatal Deaths ◽  
Normal Birth ◽  
Perinatal Mortality Rate ◽  
Still Births ◽  
Early Neonatal Deaths

Abstract: Perinatal death is a big problem especially in a developing country. Some of the hospitals in Indonesia have declared that the number of perinatal death in developing countries is higher than in  developed countries. The purpose of this research is to determine the incidence of the factors that affecting perinatal mortality at Prof. DR. R. D. Kandou General Hospital Manado. This research used retrospective descriptive method through medical records of perinatal deaths patients. There were 164 cases of perinatal deaths found where 109 cases still births and 55 cases were early neonatal deaths in 2011, so the number of perinatal mortality rate was 40.17 per mil. The highest number of perinatal death was from multigravide mother, mother with age  ≥ 35 years old, spontaneous parturition. There were unknown caused of still births cases (77,06%) and sepsis in early neonatal deaths. The normal birth weight is also with most include of perinatal deaths. Keywords: still birth, early neonatal death, perinatal deaths, perinatal mortality rate.     Abstrak: Kematian perinatal merupakan masalah besar khususnya di negara sedang berkembang. Beberapa rumah sakit pendidikan di Indonesia melaporkan angka kematian perinatal yang tinggi dibandingkan dengan laporan angka kematian perinatal di negara – negara maju yang jumlahnya rendah. Tujuan penelitian untuk mengetahui angka kejadian kematian perinatal serta faktor – faktor yang mempengaruhinya. Penelitian ini menggunakan metode deskriptif retrospektif dengan menggunakan data catatan medik pasien. Hasil penelitian yaitu jumlah kematian perinatal pada tahun 2011 sebanyak 164 kasus dengan 109 kasus lahir mati dan 55 kasus kematian neonatal dini sehingga angka kematian perinatal pada tahun 2011 yaitu 40.17 per mil. Kematian perinatal paling banyak pada ibu multigravida, ibu dengan kelompok usia ≥ 35 tahun, menggunakan jenis persalinan spontan. Pada lahir mati 77.06 % penyebab kematiannya tidak diketahui sedangkan sepsis paling banyak menyebabkan kematian neonatal dini. Berat badan lahir normal juga menjadi salah satu faktor terjadinya kematian perinatal. Kata kunci: lahir mati, kematian neonatal dini, kematian perinatal, angka kematian perinatal.

scholarly journals Trends and Determinants of Perinatal Mortality in a Tertiary Care Hospital of Nepal

2021 ◽  
Vol 20 (1) ◽  
pp. 77-82
Author(s):  
Yuba Nidhi Basaula ◽  
Radha Kumari Paudel ◽  
Ram Hari Chapagain
Keyword(s):  
Mortality Rate ◽  
Perinatal Mortality ◽  
Neonatal Sepsis ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Care Hospital ◽  
Perinatal Deaths ◽  
Neonatal Deaths ◽  
Perinatal Mortality Rate ◽  
Increasing Trend

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 17.6% of total deaths. Deaths related to unexplained intrauterine fetal death (IUFD) showed an increasing trend and have increased by more than 20% in past two years from 39.1% to 60.8%. Deaths due to perinatal asphyxia, neonatal sepsis, respiratory distress syndrome and extreme prematurity were increased. Conclusions: PMR over the two years has shown increasing trend at our institute. There is need to improve antenatal, obstetric as well as intra-partum services to further reduce the still birth as well as deaths due to prematurity, RDS, neonatal sepsis and perinatal asphyxia.

scholarly journals Maternal and Perinatal Mortality in the 21st Century

2016 ◽  
Vol 10 (2) ◽  
pp. 143-146
Author(s):  
Aris Antsaklis
Keyword(s):  
Perinatal Mortality ◽  
21St Century ◽  
Maternal Mortality Ratio ◽  
Geographic Area ◽  
Developed Countries ◽  
Sub Saharan Africa ◽  
Maternal Deaths ◽  
Neonatal Deaths ◽  
Live Births ◽  
Sub Saharan

ABSTRACT The maternal mortality ratio measures how safe it is to become pregnant and give birth in a geographic area or a population. The total number of maternal deaths observed annually fell from 526,000 in 1980 to 358,000 in 2008, a 34% decline over this period. Similarly, the global MMR declined from 422 in 1980 to 320 in 1990 and was 250 per 100,000 live births in 2008, a decline of 34% over the entire period and an average annual decline of 2.3%. More specifically, in 1990 around 58% of maternal deaths worldwide occurred in Asia and 36% in sub-Saharan Africa. In contrast, in 2008, 57% of global maternal deaths occurred in sub-Saharan Africa and 39% in Asia. In Europe, the main causes of death from any known direct obstetric complication remains bleeding (13%), thromboembolic events (10.1%), complicationassociated birth, hypertensive disease of pregnancy (9.2%), and amniotic fluid embolism (10.6%). Preterm birth is the most common cause of perinatal mortality (PNM) causing almost 30% of neonatal deaths, while birth defects cause about 21% of neonatal deaths. The PNM rate refers to the number of perinatal deaths per 1,000 total births. Perinatal mortality rate may be below 10 for certain developed countries and more than 10 times higher in developing countries. Perinatal health in Europe has improved dramatically in recent decades. In 1975, neonatal mortality ranged from 7 to 27 per 1,000 live births in the countries that now make up the EU. By 2005, it had declined to 8 per 1,000 live births. We need to bring together data from civil registration, medical birth registers, hospital discharge systems in order to have European Surveys which present exciting research possibilities. How to cite this article Antsaklis A. Maternal and Perinatal Mortality in the 21st Century. Donald School J Ultrasound Obstet Gynecol 2016;10(2):143-146.

scholarly journals A STUDY ON PERINATAL MORTALITIES AND ITS DETERMINANTS AT A TERTIARY HOSPITAL IN A METROPOLITAN CITY.

2020 ◽  
pp. 1-4
Author(s):  
Wani Reena J
Keyword(s):  
High Risk ◽  
Mortality Rate ◽  
Perinatal Mortality ◽  
Tertiary Hospital ◽  
P Value ◽  
Chi Square ◽  
Perinatal Deaths ◽  
Neonatal Deaths ◽  
Perinatal Mortality Rate ◽  
Study Results

The aim of the study is to estimate the perinatal mortality rate and its determinants. Aretrospective 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.

scholarly journals Outcomes of Pregnancy-Related Referrals From Rural Health Facilities to Two Central Hospitals in Harare, Zimbabwe: A Prospective Descriptive Study

2020 ◽  
Author(s):  
William Busumani ◽  
Paddington Mundagowa
Keyword(s):  
Mortality Rate ◽  
Blood Transfusion ◽  
Rural Health ◽  
Perinatal Mortality ◽  
Rural Women ◽  
Perinatal Outcomes ◽  
Descriptive Study ◽  
Health Facilities ◽  
Maternal Deaths ◽  
Healthcare Facilities

Abstract BackgroundBetween the years 2000 and 2017, the global maternal mortality rate dropped by 38% however, 94% of all maternal deaths still emanated from low and lower-middle-income countries. Rural women at a significantly higher risk of dying from pregnancy when compared to women living in urban settings and early detection of complications as well as prompt referral to higher levels of care can reduce the associated maternal and perinatal mortality. This study aimed to determine the maternal and perinatal outcomes of pregnancy-related referrals from rural health facilities to two central hospitals in Harare, Zimbabwe.MethodsA prospective descriptive study was conducted using a sample of 206 patients. All mothers who were referred from rural healthcare facilities were recruited for participation. Data were extracted from patient notes using a structured questionnaire and missing information was obtained from the mother after she had recovered. Bivariate analysis was done using IBM SPSS.ResultsThe average age of study participants was 27.4±7.7 years. 87.4% were booked and 81.6% presented to the tertiary facility with their referral notes. The major reasons for referral were previous cesarean section (20.4%) and hypertensive disorders in pregnancy (18.4%). There were nine maternal deaths thus a case fatality rate of 4.4% while the perinatal mortality rate was 151/1000 live births. Young mothers were more likely to have adverse perinatal outcomes and primiparous mothers were more likely to have a blood transfusion. Mothers who traveled for >100km to the tertiary facility and mothers who did not attend any antenatal visit were more likely to be transfused. Delivering at the rural health facility was significantly associated with receiving a blood transfusion at the tertiary facility. Mothers who did not attend antenatal clinic visits were more likely to have negative perinatal outcomes.ConclusionThe proportion of obstetric patients being referred from rural facilities to tertiary institutions for complications in Zimbabwe reveals how primary and secondary healthcare facilities are falling short of offering the services they should be offering. Equipping these facilities with skilled human resources as well as contemporary equipment could help decongest the central hospitals, reduce the adverse maternal and perinatal outcomes.

Perinatal mortality: epidemiological profile, causes and avoidable factors at a reference public maternity hospital in the State of Santa Catarina, Brazil, 2011–2015

2020 ◽  
Vol 48 (2) ◽  
pp. 162-167
Author(s):  
Carla Beatriz Pimentel Cesar Hoffmann ◽  
Lidiane Ferreira Schultz ◽  
Carla Gisele Vaichulonis ◽  
Iramar Baptistella do Nascimento ◽  
Caroline Gadotti João ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Perinatal Mortality ◽  
Perinatal Death ◽  
Maternity Hospital ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Perinatal Mortality Rate ◽  
Avoidable Death ◽  
International Statistical Classification ◽  
Epidemiological Profile

AbstractBackgroundThis study aimed to identify the perinatal mortality coefficient, the epidemiological profile, causes and avoidable factors at a reference public maternity hospital in southern Brazil.MethodsIn this cross-sectional study, 334 medical records of postpartum women and newborns were evaluated between January 1st, 2011 and December 31st, 2015. The Expanded Wigglesworth Classification was used to assess the causes of perinatal mortality and the International Statistical Classification of Diseases and Related Health Problems (ICD-10/SEADE Foundation) was used for the preventable perinatal mortality analysis. Absolute numbers and percentages were used for data analysis. The perinatal mortality formula was used to calculate the perinatal mortality rate.ResultsThe perinatal mortality rate was 13.2/1000 total births, with a predominance of white race/color; mothers were 21–30 years of age, had experienced their first pregnancy and had completed their high school education.ConclusionThe main factors associated with perinatal death were antepartum fetal death in 182 (54.49%) cases, and avoidable death through appropriate prenatal care in 234 (70.05%) cases.

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