DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20193776

Analysis of still births in a tertiary care system and changed scenario over six year period

Rita Mittal, Shivika Mittal, Anubala Chandel, Poonam Samyal

Abstract


                       

Background: In India, the maternal and infant mortality rates have been steadily decreasing in recent years, but there has been no corresponding decrease in the perinatal mortality. Hence, there is need to evaluate the factors leading to this unfortunate event. The objective of this study was to find out various factors (especially preventable) responsible for perinatal stillbirths.

Methods: An analytical comparative study in a tertiary care hospital comparing fresh and macerated still births over a period of one year in 2011 and 2017 and responsible factors were analysed.

Results: Amazingly, despite improvement in the antenatal services, more institutional deliveries, there is no change in the incidence of still birth rate. However, there was decrease in the rate of still births due to extreme prematurity and congenital malformations. There was no change in incidence of PIH/ Eclampsia, IUGR and placental causes but there was substantial increase in the incidence of GDM.

Conclusions: Perinatal mortality can definitely be reduced by strengthening and improving quality of antenatal services, early identification of high risk pregnancies, timely referral and appropriate intervention.


Keywords


Eclampsia, IUGR, Prematurity, PIH, Still birth

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References


Mueller RF, Virginia PS, Johnson J, Brown ZA, Chen WJ. Evaluation of a protocol for post-mortem examination of stillbirths. N Engl J Med. 1983;309:586-90.

Goldenberg RL, Kirby R, Culhane JF. Stillbirth: a review. J Matern Fetal Neonatal Med. 2004;16(2):79-94.

Victoria MA, Joseph KS, Kellie EM, Laura AM, Ohlsson A. The effect of hypertensive disorders in pregnancy on small for gestational age and stillbirth: A population study. BMC Based Preg Childbirth. 2004;4:17.

Goldenberg RL, Koski JF, Boyd BW, Cutter GR, Nelson KG. Fetal deaths in Alabama 1974 to 1983: a birth weight-specific analysis. Obstet Gynecol. 1987;70:831-5.

Stanton C, Lawn JE, Rahman H, Wilczynska KK, Hill K. Stillbirth rates: delivering estimates in 190 countries. Lancet. 2006;367(9521):1487-94.

Lawn J, Shibuya K, Stein C. No cry at birth: global estimates of intrapartum stillbirths and intrapartum-related neonatal deaths 2005. Bull World Health Organ. 2005;83(6):409-17.

McClure EM, Saleem S, Pasha O, Goldenberg RL. Stillbirth in developing countries: a review of causes, risk factors and prevention strategies. J Matern Fetal Neonatal Med. 2009;22(3):183-90.

McClure EM, Wright LL, Goldenberg RL, Goudar SS, Parida SN, Jehan I. The global network: a prospective study of stillbirths in developing countries. Am J Obstet Gynecol. 2007;197(3).

TE, Sinkala M, Brown ER, Valentine M, Martinsen F, Goldenberg RL. Predictors of stillbirth in sub-Saharan Africa. Obstet Gynecol. 2007;110:989-90.

Goldenberg RL, McClure EM, Althabe F. National Institute of Population Studies (NIPS) Pakistan, and Macro International Inc: Pakistan Demographic and Health Survey 2006-07. Islamabad, Pakistan: 2008.

Jehan I, McClure EM, Salat S. Stillbirths in an urban community in Pakistan. Am J Obstet Gynecol. 2007;197:257-60.

Hinderaker SG, Olsen BE, Bergsjo PB. Avoidable stillbirths and neonatal deaths in rural Tanzania. BJOG. 2003;110:616-23.