scholarly journals Caesarean Section and Perinatal Mortality in South Western Nigeria

1970 ◽  
Vol 4 (1) ◽  
pp. 46-48
Author(s):  
OC Ezechi ◽  
OM Loto ◽  
VI Ndububa ◽  
FO Okogbo ◽  
PM Ezeobi ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Perinatal Mortality ◽  
Caesarean Delivery ◽  
Health Workers ◽  
Perinatal Death ◽  
Fetal Loss ◽  
Birth Asphyxia ◽  
Neonatal Deaths ◽  
Health Delivery ◽  
June July

Aim: Caesarean section carries a substantial hazard to the unborn fetus, especially if done as an emergencyprocedure. In our environment fetal loss following a caesarean delivery is usually attributed to the procedureby patients and relations who do not readily accept caesarean section as a delivery option.Method: A 10 year descriptive study of caesarean section related perinatal mortality in four tertiary hospitalsin South western Nigeria.Results: Nineteen thousand one hundred and seventy nine deliveries were conducted in the hospitalsduring the study period; five thousand one hundred and ninety five (27.1 %) of which were caesareandeliveries. Two hundred and thirty five of the caesarean deliveries were associated with perinatal death (6.9%.). Majority of these deaths were among the unbooked (73.8%), multiparous (69.0 %) patients and emergencycaesarean delivery (83.4%). Prolonged/ obstructed labour (45.4%), preeclampsia/eclampsia (18.8%) andfetal distress (11.5%), were the commonest indication for caesarean deliveries. While majority of the perinataldeath were still born (60.3%), (39.7%) were early neonatal deaths. The common causes of early neonataldeath in these patients were severe birth asphyxia (37.4 %), neonatal sepsis (22.0%) and prematurity (16.4%).Conclusion: The cause of perinatal mortality associated with caesarean delivery in our environment arepreventable with public enlightenment, provision of affordable and accessible prenatal and neonatal care,discipline, behavioural and attitudinal change of health workers, and the political will on the part of policymakers to maternal and child health delivery care more effective.DOI: 10.3126/njog.v4i1.3332Nepal Journal of Obstetrics and Gynaecology June-July 2009; 4(1): 46-48

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.

Study of obstetric factors in perinatal morbidity and mortality at a tertiary centre

2017 ◽  
Vol 7 (1) ◽  
pp. 198
Author(s):  
Sanjaykumar G. Tambe ◽  
Yogesh A. Thawal ◽  
Tania Anand ◽  
Dipak Suresh Kolate
Keyword(s):  
Perinatal Mortality ◽  
Health Care Providers ◽  
Perinatal Death ◽  
Golden Rule ◽  
Vital Statistics ◽  
Safe Motherhood ◽  
Care Providers ◽  
Perinatal Deaths ◽  
Neonatal Deaths ◽  
Tertiary Center

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.

scholarly journals A retrospective analysis of the risk factors leading to perinatal mortality at a tertiary care hospital of Sikkim, India

2018 ◽  
Vol 7 (6) ◽  
pp. 2295
Author(s):  
Chanda Rai ◽  
Latha V. Kharka ◽  
Sudip Dutta ◽  
Nishant Kumar
Keyword(s):  
Risk Factors ◽  
Health Services ◽  
Perinatal Mortality ◽  
Tertiary Care ◽  
Fetal Loss ◽  
Birth Asphyxia ◽  
Care Hospital ◽  
Tertiary Referral Hospital ◽  
Perinatal Deaths ◽  
Medical Disorders

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, increased basal metabolic index and inadequate ante-natal care caused increased perinatal losses.Conclusions: Perinatal grief continues to surround women who have suffered perinatal deaths and  serious efforts should be made to bring down the mortality rates by improving health , nutrition of all expecting mothers  and increase their awareness to seek ante-natal health services in order  to avoid any catastrophe in terms of maternal and fetal loss.

Contributing factors to perinatal mortality among women who gave birth at the Jimma University Medical Centre, southwest Ethiopia

2021 ◽  
Vol 15 (3) ◽  
pp. 1-10
Author(s):  
Tekle Wakjira ◽  
Dejene Asefa ◽  
Geremew Muleta ◽  
Dessalegn Tamiru
Keyword(s):  
Perinatal Mortality ◽  
Rural Areas ◽  
Maternal Education ◽  
Perinatal Death ◽  
Statistical Significance ◽  
Study Participant ◽  
Medical Centre ◽  
Contributing Factors ◽  
Neonatal Deaths ◽  
Jimma University

Background Perinatal mortality remains a challenge worldwide, particularly in developing countries. Although significant achievements have been made to reduce neonatal mortality worldwide, in the last two decades there was a total of 5.3 million neonatal deaths and stillbirths each year. This study aims to assess the magnitude of perinatal mortality and its contributing factors among births at the Jimma University Medical Centre in Ethiopia. Method A facility-based cross-sectional study was conducted between January and April 2017. Convenience sampling was used to select study participants and data were collected using interviewer-administered pretested structured questionnaires. Descriptive statistics were used to analyse the data, with the chi-square test used to assess the relationship between each factor and outcome. Statistical significance was set at P<0.05. Results The rate of perinatal death was 107 per 1000 births, of which 39.2%, 25.9% and 34.9% were fresh stillbirths, macerated stillbirths and early neonatal deaths respectively. The majority (77.8%) of stillbirths occurred before the study participant reached the hospital and 64.3% of stillbirths had low birth weight. Hyaline membrane disease (27.6%) and meconium aspiration syndrome (20.7%) were the two most common causes of early perinatal death. Obstetric complications contributed to 89.6% of perinatal deaths. Stillbirth was significantly associated with a lack of education (P=0.036). The rate of perinatal mortality was high among women with their first pregnancy (53.0%) and those who had no previous pregnancy-related problems (79.5%), and was significantly associated with mechanical causes and antepartum haemorrhage (P=0.015). Conclusions The findings indicated that the rate of perinatal mortality was high at the Himma University Medical Centre. Improving maternal education and health services in rural areas are important steps to prevent poor perinatal outcomes. Facilitating transport and improving referral procedures may help to prevent mechanical complications, which are the most common cause of perinatal death, particularly fresh stillbirths which, in the present study, often occurred before a participant arrived at the hospital.

scholarly journals Travel time and perinatal mortality after emergency caesarean sections: an evaluation of the 2-hour proximity indicator in Sierra Leone

2020 ◽  
Vol 5 (12) ◽  
pp. e003943
Author(s):  
Alex J van Duinen ◽  
Håvard A Adde ◽  
Ola Fredin ◽  
Hampus Holmer ◽  
Lars Hagander ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Travel Time ◽  
Perinatal Mortality ◽  
Perinatal Death ◽  
Linear Regression Analysis ◽  
Perinatal Outcomes ◽  
Emergency Obstetric Care ◽  
Travel Times ◽  
Time Model ◽  
Patient Reported

IntroductionLonger travel times are associated with increased adverse maternal and perinatal outcomes. Geospatial modelling has been increasingly used to estimate geographic proximity in emergency obstetric care. In this study, we aimed to assess the correlation between modelled and patient-reported travel times and to evaluate its clinical relevance.MethodsWomen who delivered by caesarean section in nine hospitals were followed up with home visits at 1 month and 1 year. Travel times between the location before the delivery and the facility where caesarean section was performed were estimated, based on two models (model I Ouma et al; model II Munoz et al). Patient-reported and modelled travel times were compared applying a univariable linear regression analysis, and the relation between travel time and perinatal mortality was assessed.ResultsThe median reported travel time was 60 min, compared with 13 and 34 min estimated by the two models, respectively. The 2-hour access threshold correlated with a patient-reported travel time of 5.7 hours for model I and 1.8 hours for model II. Longer travel times were associated with transport by boat and ambulance, visiting one or two facilities before reaching the final facility, lower education and poverty. Lower perinatal mortality was found both in the group with a reported travel time of 2 hours or less (193 vs 308 per 1000 births, p<0.001) and a modelled travel time of 2 hours or less (model I: 209 vs 344 per 1000 births, p=0.003; model II: 181 vs 319 per 1000 births, p<0.001).ConclusionThe standard model, used to estimate geographical proximity, consistently underestimated the travel time. However, the conservative travel time model corresponded better to patient-reported travel times. The 2-hour threshold as determined by the Lancet Commission on Global Surgery, is clinically relevant with respect to reducing perinatal death, not a clear cut-off.

scholarly journals Measuring the effectiveness of maternal delivery services: A cross-sectional and qualitative study of perinatal mortality in six primary referral hospitals, Kenya

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 732
Author(s):  
Richard Ayah ◽  
Dismas Ongore ◽  
Alfred T.O. Agwanda
Keyword(s):  
Caesarean Section ◽  
Health System ◽  
Perinatal Mortality ◽  
Perinatal Death ◽  
Caesarean Section Rate ◽  
Public Hospitals ◽  
Standards Of Care ◽  
Cross Sectional ◽  
Referral Hospitals ◽  
Delivery Services

Background: The effective performance of hospitals is critical to overall health system goal achievement. Global health system performance frameworks are often used as part of global benchmarking, but not within low and middle-income countries as part of service delivery performance measurement. This study explored the utility of perinatal mortality as a measure of hospital effectiveness. Methods: A cross sectional, mixed methods study of six primary referral hospitals, differentiated by ownership, was conducted from 10th June to 9th October 2015. Monthly summary hospital data of maternal delivery services (MDS) were abstracted to determine the perinatal mortality. Tests of associations were used to correlate bed turnover, skilled staffing, method of delivery and perinatal mortality. Additionally, 40 questionnaire interviews were held with hospital board members and the management team to assess the availability of standard operating procedures (SOP) in MDS. Qualitative data was analysed thematically. Results: All six hospitals reported having SOP in managing MDS. The average perinatal mortality rate for all the hospitals was 24.63 per 1,000 live births. However, a perinatal death was 2.6 times more likely in public hospitals compared to private hospitals (29.8 vs 11.4 per 1,000 births respectively). The average caesarean section rate for all hospitals was 25.9%, but the odds of a caesarean section were 1.67 higher in a private hospital compared to a public hospital (P<0.001 95% CI: 1.58-1.77). Perinatal mortality was associated with bed turnover ratio (R squared 0.260, P=0.001), and skilled staff availability (R squared 0.064,P<0.001). Discussion: The high perinatal mortality reported in public hospitals may be due to high bed turnover and relatively low caesarean section rate. Input measures of performance such as reporting standards of care and staffing levels are not useful performance indicators. Perinatal mortality as a performance indicator may be an ideal measure of the effectiveness of hospitals.

scholarly journals Feto maternal outcome in eclampsia after 28 weeks of pregnancy: vaginal delivery versus caesarean section

2017 ◽  
Vol 6 (9) ◽  
pp. 3875
Author(s):  
Bhawna Madan
Keyword(s):  
Caesarean Section ◽  
Perinatal Mortality ◽  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Signs And Symptoms ◽  
Fetal Outcome ◽  
Maternal Complications ◽  
Maternal Deaths ◽  
Neonatal Deaths ◽  
Still Births

Background: Eclampsia is the occurrence of convulsions or coma unrelated to other cerebral condition with signs and symptoms of preeclampsia. Objective of present study was the comparison of maternal and fetal outcome of women with more than 28 weeks gestation complicated by antepartum eclampsia when terminated either by caesarean section or by vaginal delivery.Methods: 200 Women with more than 28 weeks of gestation with antepartum eclampsia were studied from admission to discharge or death. Depending upon the mode of delivery, they were divided into two groups: C.D. group. Where caesarean section was performed and V.D. group, where vaginal delivery was carried out. Maternal and Perinatal outcome were studied in the two groups and compared.Results: Of the 200 cases, caesarean section was done in 40% of the cases, while vaginal delivery was carried out in 60%. Maternal complications were seen in 15% of the cases in the C.D group and 60% of the cases in the V.D. group. Maternal deaths occurred in none of the case in the C.D group and in 33% of the cases in the V.D group. The incidence of live births, still births and neonatal deaths was 87.8%, 2.43% and 9.75% respectively in the C.D group, while it was 49.16%, 45.16% and 9.67% in the V.D group The Corrected perinatal mortality was 9.75% in the C.D group and 43.55% in the V.D group. Apgar score less than 5 at l minute was seen in 35% cases in the C.D group and 82.35% cases in the V.D group.30% of the cases in the C.D group and 76.47% of the cases in the V.D group required NICU admission.Conclusions: Timely caesarean section reduces maternal and Perinatal mortality and improves their outcome in antepartum eclampsia, especially in women with more than 28 weeks of pregnancy.

scholarly journals Status of Perinatal Mortality in Karnali Academy of Health Sciences, Jumla Nepal

2019 ◽  
Vol 2 (2) ◽  
pp. 120-125
Author(s):  
Namrata Sindan ◽  
Sandeep Shrestha ◽  
Bishnu Dutta Acharya ◽  
Purnima Rai ◽  
Nirajana Kayastha ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Perinatal Mortality ◽  
Neonatal Sepsis ◽  
Neonatal Death ◽  
Perinatal Death ◽  
Birth Asphyxia ◽  
Health Sciences ◽  
Early Neonatal Death ◽  
Perinatal Mortality Rate

Introduction:  Perinatal mortality rate is sensitive indicator of quality of obstetric and pediatric health services. It also helps us to evaluate efficiency of health care provided by a particular hospital. The aim of this study was to evaluate the cause of perinatal death in a tertiary care medical centre, which may help to reduce the incidence of perinatal death and improve the quality of care. Methods: The two-year retrospective study of perinatal deaths was done at Karnali Academy of Health Sciences (KAHS), Jumla from March 2017 to April 2019. Data was collected from monthly perinatal audit and annual mortality reviews. Registers in the maternity ward, sick Neonate Care Unit, and files of dead newborns kept in the record section of the hospital were studied and reviewed. Results: A total of 1354 deliveries were conducted in the 24 months period at KAHS with perinatal mortality rate of 36.08 per 1000 total birth and early neonatal death rate of 12.8 per 1000 live birth. The Perinatal mortality was higher in low birth weight and premature baby. The cause of stillbirth and early Neonatal death were identified. Most of the early neonatal death was due to Prematurity (41.17%) followed by Birth Asphyxia and Neonatal Sepsis. Conclusion: Prematurity and its related complication were the most common cause of early neonatal death followed by birth Asphyxia and Neonatal Sepsis. There is need to improve antenatal, early identification of high-risk pregnancy as well as Neonatal Intensive Care Unit (NICU) to further reduce deaths due to prematurity and birth asphyxia.

Extended Perinatal Mortality Audit in a Rural Hospital in India

2021 ◽  
Author(s):  
Núria Torre Monmany ◽  
Joaquín Américo Astete ◽  
Dasarath Ramaiah ◽  
Jyothi Suchitra ◽  
Xavier Krauel ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Perinatal Mortality ◽  
Perinatal Death ◽  
Gestational Hypertension ◽  
Action Plan ◽  
Previous History ◽  
Rural Hospital ◽  
Neonatal Deaths ◽  
The Status ◽  
History Of

Objective The aim of the study is to describe the status of perinatal mortality (PM) in an Indian rural hospital. Study Design Retrospective analysis of data was compiled from PM meetings (April 2017 to December 2018) following “Making Every Baby Count: audit and review of stillbirths and neonatal deaths (ENAP or Every Newborn Action Plan).” Results The study includes 8,801 livebirths, 105 stillbirths (SBs); 74 antepartum stillbirths [ASBs], 22 intrapartum stillbirths [ISBs], and nine unknown timing stillbirths [USBs]), 39 neonatal deaths or NDs (perinatal death or PDs 144). The higher risks for ASBs were maternal age >34 years, previous history of death, and/or SBs. Almost half of the PDs could be related with antepartum complications. More than half of the ASB were related with preeclampsia/eclampsia and abruptio placentae; one-third of the ISB were related with preeclampsia/eclampsia and gestational hypertension, fetal growth restriction, and placental dysfunction. The main maternal conditions differed between PDs (p = 0.005). The main causes of the ND were infections, congenital malformations, complications of prematurity, intrapartum complications, and unknown. The stillbirth rate was 11.8/1,000 births, neonatal mortality rate 4.4/1,000 livebirths, and perinatal mortality rate 15.8/1,000 births. Conclusion This is the first study of its kind in Andhra Pradesh being the first step for the analysis and prevention of PM. Key Points

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