Abstract
This retrospective study was conducted to find out the status of perinatal mortality at Nepal Medical College Teaching Hospital (NMCTH) which is located at sub-urban area of Kathmandu. Records of all consecutive deliveries from 1/7/1998 to 30/12/2002 were reviewed. Total number of deliveries was 1517 among which 1182(77.9%)were normal deliveries. Total number of birth was 1531 including 14 set of twins. There were 38 still birth (24.8 per 1000 birth) and 7 early neonatal deaths (4.7 per 1000 live birth). The perinatal mortality rate was 29.4 per 1000 birth. Perinatal mortality was higher in low birth weight babies (77%) and premature (173.2%). Most of the cases (46.7%) have not attended regular Ante-natal Checkup (ANC). Among 38 cases of still birth 27 were macerated. Abruptio placenta and pregnancy induced hypertension were common identifiable causes of Intra-uterine Death (IUD) whereas among 7 cases of Early Neonatal Death (ENND) 4 cases were due to pre-maturity with hyaline membrane disease. Regular ante natal care with identification of high risk group and management of complications along with improved neonatal care facilities will help to minimize the high perinatal mortality rate. Regular perinatal death audit is necessary to identify the common and preventable causes of perinatal mortality. (authors)
Highlights
Perinatal Mortality Rate (PMR) is markedly reduced in developed countries since last two decades
PMR gives an idea of standard of perinatal services available there The PMR vary from less than 10 in Japan and Germany to as high as 80 or even 100/1000 births in the least developed countries
Regular perinatal death audit is essential in an institution to find out the avoidable factors in related to perinatal deaths
Summary
Perinatal Mortality Rate (PMR) is markedly reduced in developed countries since last two decades. PMR gives an idea of standard of perinatal services available there The PMR vary from less than 10 in Japan and Germany to as high as 80 or even 100/1000 births in the least developed countries. The most developing countries have rates around 35 to 60 per 1000.2 The important obstetric causes of perinatal deaths are prolonged/difficult labour, antepartum haemorrhage, hypertensive diseases of pregnancy, chronic maternal diseases and congenital abnormalities. The leading factors among fetal and neonatal causes of perinatal mortality are birth asphyxia/trauma, prematurity, congenital malformation and infections.[4,5,6,7] Factors influencing the perinatal mortality rates are maternal age, parity, number of antenatal visits, maternal health and socioeconomic status
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