Causes of perinatal death at Ramathibodi Hospital, Bangkok, Thailand.

Abstract

Study of autopsy cases of infant deaths occurring during 1969-1970 at Ramathibodi Hospital in Bangkok undertaken to provide information on levels of fetal and neonatal death in developing countries. Findings are examined in conjunction with similar studies in other parts of the world. Of the 733 cases considered 128 were stillbirths or deaths in utero; the rest (605) were neonatal deaths. For the purposes of this study cases are classified according to body weight into 3 groups: 501-1000 gm; 1001-2500 gm; and over 2500 gm. Results show 52% of fetal deaths to be without known cause even after complete autopsy. Anoxia is the major known cause of fetal death accounting for 22% of deaths in utero. In the neonate hyaline membrane disease proved to be the major cause of death (25%) followed by congenital malformations (16%) and pneumonia (12%). In those with birth weights over 2500 gm infection especially of the lungs is a common cause of death. In the last 3 years (1977-1979) however the incidence of hyaline membrane disease and infection as causes of death has increased. Overall hyaline membrane disease in infants under 2500 gm is the major cause of death in neonates and infants considered together followed closely by malformations and anoxia. Pneumonia and other septic conditions combined are the second leading cause of fetal and neonatal deaths.