scholarly journals An Analysis of Causes and Avoidable Factors of Perinatal Deaths at Tertiary Care Hospital

2021 ◽  
Vol 4 (1) ◽  
pp. 424-428
Author(s):  
Sunita Bhandari ◽  
Yam Dwa ◽  
Riya Sharma
Keyword(s):  
Health Care ◽  
Mortality Rate ◽  
Perinatal Mortality ◽  
Tertiary Care ◽  
Care Hospital ◽  
Perinatal Deaths ◽  
Seek Health Care ◽  
Danger Signs ◽  
Perinatal Mortality Rate ◽  
Antenatal Counseling

Introduction: Perinatal deaths are potentially preventable and reflect the quality of care provided in the prenatal period, during labor, and to a newborn. The purpose of this study was to assess the causes and avoidable factors contributing to perinatal deaths in the year 2018-19 and compare these with the previous two years at Tertiary Care Hospital.Materials and Methods: This study was conducted from a retrospective analysis of all stillbirths and early neonatal deaths in the year July 2018 to July 2019. The Perinatal Mortality Rate, causes, and avoidable factors leading to perinatal deaths were analysed during this year and were compared with that of the previous two years at KIST Medical College and Teaching hospital.Results: PMR was 16.09 per 1000 births in the year 2018-19. Previous two studies at this hospital in the year 2017-18 and 2016-17 showed a Perinatal Mortality Rate of 14.61 and 16.27/1000 births respectively. The commonest primary cause of perinatal deaths was intrapartum hypoxia 6 (30%), preterm delivery 5 (31.25%), and congenital anomalies4 (19%) during the year 2018-19, 2017-18, and 2016-17 respectively. The most common avoidable factors identified were a maternal delay to seek health care, inadequate antenatal checkups, and inadequate antenatal counseling of danger signs by a service provider over the last three years.Conclusions: Maternal delay to seek health care and lack of maternal knowledge of danger signs during pregnancy were the common avoidable factors identified. More efforts should be made to raise awareness of pregnant women during antenatal care visits regarding early healthcare-seeking behavior when needed.

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 Perinatal Mortality Review in a Tertiary Care Hospital: Way Forward to Address SDG Health Goal 3

2019 ◽  
Vol 18 (1) ◽  
pp. 69-74
Author(s):  
Manisha Bajracharya ◽  
Ang Tshering Sherpa ◽  
Ajay Dhakal ◽  
Sunita Bhandari ◽  
Heera Tuladhar ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Perinatal Mortality ◽  
Congenital Anomalies ◽  
Perinatal Death ◽  
Tertiary Care ◽  
Well Being ◽  
Hypertensive Disorder ◽  
Care Hospital ◽  
Perinatal Deaths ◽  
Perinatal Mortality Rate

Introduction: Sustainable development goal 3 targets at ensuring healthy lives and promoting well-being for all at all ages. One of the component for achievement of this goal is improvement of maternal and child health; the indicators of which is perinatal mortality rate. 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: A prospective study was done over a period of one year from April 2016 to March 2017. Causes of perinatal deaths based on PSANZ classification were recorded along with patients demographics and also avoidable factors were evaluated. Results: Out of total 1275 deliveries, there were 21 perinatal deaths including three intrauterine foetal deaths, one still birth and seven early neonatal deaths. The perinatal mortality rate was 16.27 per 1000 birth. Majority of perinatal deaths (19%) occurred due to congenital anomalies followed by (14%) hypertensive disorder in pregnancy, intrapartum hypoxia (14%), unexplained causes (14%), 9.5% cord prolapse, antepartum haemorrhage (9.5%), 5% due to intrauterine growth restriction, gestational diabetes mellitus or preterm labour. Most of the mothers whose baby had perinatal deaths had ANC outside. Most of the deaths occurred in between gestational age of 37 to 41 weeks. Perinatal mortality was more in multigravida. Delay to seek health care and inadequate antenatal checkups were the most common avoidable factors. Conclusions: Congenital anomalies and hypertensive disorders during pregnancy were the most common causes of perinatal death. Delay in health seeking behaviour was the most common avoidable factors for perinatal death. We recommend early identification of high risk pregnancy through proper antenatal screening, educating pregnant women to identify danger signs of pregnancy, creating public awareness about importance of antenatal checkups, vigilant labour monitoring for foetal distress, to reduce some categories of deaths.  

scholarly journals Prevalence of Perinatal Deaths in A Tertiary Care Hospital of Nepal

2019 ◽  
Vol 57 (217) ◽  
Author(s):  
Yam Dwa ◽  
Sunita Bhandari
Keyword(s):  
Mortality Rate ◽  
Perinatal Mortality ◽  
Teaching Hospital ◽  
Perinatal Death ◽  
Tertiary Care ◽  
Neonatal Care ◽  
Preterm Neonates ◽  
Care Hospital ◽  
Perinatal Deaths ◽  
Perinatal Mortality Rate

Introduction: Perinatal mortality indicates quality of maternal and neonatal care and is high inNepal. This study was conducted to find out the prevalence of perinatal deaths in a tertiary carecenter. Methods: This descriptive cross-sectional study was conducted from July 2017 to June 2018 at KISTMedical College and Teaching Hospital. Details of each perinatal death were filled in predesignedproforma from hospital in-patient records within 24 hours of perinatal death. The total of 1088 caseswere selected for the study and convenience sampling was done. Statistical analysis was done withStatistical Package for Social Sciences (SPSS 17.0). Results: Out of 1088 births selected for the study, there were 16 cases of perinatal deaths. Hence,the prevalence of the perinatal deaths in KIST Medical College and Teaching Hospital is found to be1.47%. In the same way, perinatal mortality rate, stillbirth rate and early neonatal mortality rate werecalculated and found to be 14.61 per 1000 births, 8.21 per 1000 births and 6.44 per 1000 live birthsrespectively. Preterm neonates constituted of 71.4% of early neonatal deaths. Conclusions: Perinatal mortality rate was 50% lower than that of national survey, however comparablewith study at another tertiary care center at Kathmandu. Stillbirth and prematurity contributedsignificantly to perinatal mortality. Provision of good antenatal surveillance, identification of highrisk pregnancies and good neonatal care to preterm neonates would be required to reduce perinatalmortality.

scholarly journals FREQUENCY AND CAUSES OF PERINATAL MORTALITY IN A TERTIARY CARE HOSPITAL IN PESHAWAR, PAKISTAN

2018 ◽  
Vol 16 (1) ◽  
pp. 15-19
Author(s):  
Maimoona Qadir ◽  
Sohail Amir ◽  
Samina Jadoon ◽  
Muhammad Marwat
Keyword(s):  
Mortality Rate ◽  
Perinatal Mortality ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Age Groups ◽  
Mortality Data ◽  
Care Hospital ◽  
Cross Sectional ◽  
Medical Disorders ◽  
Perinatal Mortality Rate

Background: Perinatal mortality rate indicates quality of care provided during pregnancy and delivery to the mother and to the neonate in its early neonatal period. The objective of this study was to determine the frequency and causes of perinatal mortality in a tertiary care hospital in Peshawar, Pakistan. Materials & Methods: This cross-sectional study was conducted at Department of Gynaecology & Obstetrics, Khyber Teaching Hospital, Peshawar, Pakistan from 1st January 2016 to 31st December 2016. The inclusion criteria was all singleton gestation with gestational age of at least 24 weeks presenting with perinatal mortality. Data was collected for the following variables; age groups (up to 20 years, 21-30 years, 31-40 years and > 40 years), booking status (yes/ no), period of gestation (24-31+6, 32-36+6, 37-39+6 and > 40 weeks), Foetal weight ( 3.5 kg) and cause of perinatal mortality. Results: Out of 4508 deliveries there were 288 perinatal deaths, including 228 stillbirths and 60 neonatal deaths, so perinatal mortality rate was 63.8/1000 births. 90.28% women were unbooked. Most common cause was hypertensive disorders of pregnancy (27.78%) followed by antepartum haemorrhage (25.71%) and then mechanical causes (13.88%). Congenital anomalies comprised 11.8% cases, neonatal problems 10.07% and maternal medical disorders for 4.16% cases. Cause of 4.16% cases remained unexplained. Conclusion: Appropriate strategies like control of identifiable causes, proper antenatal and postnatal care, healthy delivery practices and availability of emergency neonatal care facilities can bring down perinatal mortality rates.

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 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.

scholarly journals Study of cases with perinatal mortality

2019 ◽  
Vol 8 (5) ◽  
pp. 1719
Author(s):  
Nidhi Pancholi
Keyword(s):  
Mortality Rate ◽  
Antenatal Care ◽  
Perinatal Mortality ◽  
Perinatal Loss ◽  
Pediatric Care ◽  
Entire Family ◽  
Important Indicator ◽  
Perinatal Deaths ◽  
Perinatal Mortality Rate

Background: Perinatal loss is one of the most traumatic life events. It is indeed a great psychological and emotional shock to not only the mother and father but the entire family and society as a whole. The perinatal mortality rate (PMR) is an important indicator of the quality of obstetric care during pregnancy. Perinatal deaths result largely from obstetric complications that can be prevented with proper antenatal care and quality neonatal services. The study was aims to study the factors related with perinatal loss and its prevention in future pregnancy.Methods: It was a prospective analytical study. All patients with IUFD, stillbirths and early neonatal loss were studied. Postpartum both mother and father were counselled. Detailed history and thorough physical examination were conducted. Data was recorded and tabulated, observation made and compared with results of various studies.Results: The results showed that the incidence of IUFD was 3.7% and early neonatal death was 10.8% per total admissions. The perinatal mortality rate was 63.62 per 1000 live births. Perinatal mortality rate was inversely related to the number of antenatal visits taken by the patient. Lack of antenatal care results in perinatal deaths probably due to failure of early identification and management of maternal problems that impact negatively on perinatal outcome. Even in advanced economies with sophisticated diagnostic and monitoring equipment, lack of antenatal care categorizes a pregnant woman as a high-risk pregnancy.Conclusions: There is a need for awareness regarding importance of antenatal care and institutional delivery. Perinatal mortality is an important indicator of maternal care, health and nutrition. It also reflects the quality of Obstetric and Pediatric care available. Every effort must be made to reduce perinatal mortality.

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 Time trends in twin perinatal mortality in northern England, 1982–94

Twin Research ◽  
1998 ◽  
Vol 1 (4) ◽  
pp. 189-195 ◽  
Author(s):  
Svetlana V Glinianaia ◽  
Judith Rankin ◽  
Marjorie Renwick ◽  
Keyword(s):  
Mortality Rate ◽  
Perinatal Mortality ◽  
Low Birthweight ◽  
Mortality Rates ◽  
Northern Region ◽  
Intrauterine Death ◽  
Health Care Planning ◽  
Perinatal Deaths ◽  
Perinatal Mortality Rate ◽  
Twin Pregnancies

AbstractThe dynamics of perinatal mortality rates (PNMR) and causes of death in twin pregnancies over 13 years in the Northern Region of the National Health Service in England is described. All twin perinatal deaths occurring between 1982–1994 were identified from the Northern Region Perinatal Mortality Survey. The twinning rate increased from 9.9 per 1000 maternities in 1982 to 12.0 in 1994. There was a total of 10734 twin pregnancies and of these 421 resulted in 530 perinatal deaths. The perinatal mortality rate in twins significantly decreased over time (1982–87, 55.4 per 1000; 1988–94, 44.4 per 1000; P = 0.01). The PNMR was significantly higher for twins from like-sexed than from unlike-sexed pairs (53.5 and 34.4 per 1000 respectively, P < 0.001). Despite no improvement in birthweight distribution in the twin population, birthweight-specific perinatal mortality rates for both like and unlike-sexed twins decreased for each birthweight category in 1988–94 compared with 1982–87. Twins with very low birthweight ( < 1500 g) comprised 69%, and preterm twins ( < 37 completed weeks of gestation) 74.9% of all twin perinatal deaths. The major immediate cause of early neonatal death was pulmonary immaturity (63%); antepartum anoxia caused 76.9% of antenatal deaths. Unexplained preterm labour and intrauterine death were the leading obstetric factors underlying death in twins. Despite a decrease over the 13 years, the perinatal mortality rate in twins in the Northern Region remains high. Continued monitoring of trends in twinning and mortality rates is needed to inform health care planning.

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