DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20175845

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

Sanjaykumar G. Tambe, Yogesh A. Thawal, Tania Anand, Dipak Suresh Kolate

Abstract


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.


Keywords


Antenatal care, Neonatal death, Perinatal mortality, Stillbirths

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References


The Times of India. India ranks among top 3 medical tourism destinations in Asia. Available at http://timesofindia.indiatimes.com/business/india-business/India-ranks-among-top-3-medical-tourism-destinations-in-Asia/articleshow/41447360.cms

Sujata, Das V, Agrawal A. A study of perinatal deaths at a tertiary care teaching hospital. J Obstet Gynecol India. 2008;58(3):235-8.

Korde-Nayak VN, Gaikwad PR. Causes of stillbirth. Obstet Gynecol India. 2008;58(4):314-8.

Lawn JE, Gravett MG, Nunes TM, Rubens CE, Stanton C, GAPPS Review Group. Global report on preterm birth and stillbirth (1 of 7): definitions, description of the burden and opportunities to improve data. BMC Pregnancy Childbirth. 2010;10(1):S.1

Zupan J, Aahman E. Neonatal and perinatal mortality: country, regional and global estimates 2004 developed by WHO. Geneva: World Health Organization. 2007.

Zupan J. Perinatal mortality in developing countries. NEJM. 2005;352:2047-8.

Kerber KJ, Johnson JEG, Bhutta ZA, Okong P, Starrs A, Lawn JE. Continuum of care for maternal, newborn, and child health: from slogan to service delivery. Lancet. 2007;370:1358-69.

National Family Health Survey-3: Available at http://www.nfhsindia.org/NFHS-3%20Data/VOL 1/Summary Accessed 13th October 2011.

Korde-Nayak VN, Gaikwad PR. Causes of stillbirth. Obstet Gynecol India. 2008;58(4):314-8.

Sample Registration System. Statistical report 2008, Report No. 1 of 2009. New Delhi: Office of Registrar General, India, Ministry of Home Affairs, Government of India. 2009.

Kulkarni R, Chauhan S, Shah B, Menon G, Puri C. Investigating causes of perinatal mortality by Verbal Autopsy in Maharashtra, India. Indian J Comm Med. 2007;32(4):259-63.

Kozuki N, Lee ACC, Silveira MF, Sania A, Vogel JP, Adair L, et al. The associations of parity and maternal age with small-for-gestational-age, preterm, and neonatal and infant mortality: a meta-analysis. BMC Public Health. 2013;13(3):S2.

Siddalingappa H, Murthy MR, Pravin K, Ashok NC. Prevalence and factors influencing perinatal mortality in rural Mysore, India. J Clin Diag Res. 2013;7(12):2796.

Reddy UM, Laughon SK, Sun L, Troendle J, Willinger M, Zhang J. Prep-regnancy risk factors for antepartum stillbirth in the United States. Obstet Gynecol. 2010;116(5):1119-26.

Ananth CV, Basso O. Impact of pregnancy-induced hypertension on stillbirth and neonatal mortality. Epidemiol. 2010;21(1):118-23.

Benjamin AI, Paramita S, Shavinder S. Perinatal mortality and its risk factors in Ludhiana: a population based prospective cohort study. Health and Population: Perspectives and Issues. 2009;32(1):12-20.

Dali SM, Tuladhar H, Pradhan P, Awale P, Thapa S. Perinatal death audit. J Nepal Med Assoc. 2003;42:383-6.

Bhatt AD, Meena A, Desai MR. Maternal and perinatal outcome in cases of placenta previa. Int J Sci Res (IJSR). 2014;3(1):2319-7064.

Bhattacharya S, Mukhopadhyay G, Mistry PK, Pati S, Saha SP. Stillbirth in a tertiary care referral hospital in north bengal - a review of causes, risk factors and prevention strategies. Online J Health Allied Sci. 2010;9(4):4.