Perinatal mortality audit at Jimma hospital, South- Western Ethiopia, 1990-1999

Abstract

A retrospective review of perinatal deaths that occurred during 1990-1999 at Jimma hospital, a teaching hospital in South-Western Ethiopia was conducted with the objective of determining the overall perinatal mortality rate and trend, identifying major causes and suggest possible preventive strategies. Record books of the maternity and neonatal wards were used to identify all perinatal deaths and live births that occurred during the study period and relevant sociodemographic and clinical data pertaining to the perinatal deaths were documented and analyzed. The overall perinatal mortality rate during the study period was 138.9 per thousand live births with an increasing trend. While 66.5% of perinatal deaths occurred among primigravid and grandmultiparous mothers, 52.7% were in mothers aged 20-29 years of age, and 14.9% were among teenage mothers. The majority of perinatal deaths were due to mechanical factors related to the peripartum period (53.3%), with obstructed labor with or without ruptured uterus being the single most important cause responsible for 37.4% of perinatal mortality. Other causes identified were hypertensive disorders (6.7%), lethal congenital anomalies (1.4 %), antepartum hemorrhage (2.1 %), and prematurity (7.2 %). In 28.9% of perinatal deaths, the cause could not be identified. This study has shown a high perinatal mortality rate with an increasing trend, the majority of deaths being due to mechanical factors related to the peripartum period. Analytic studies to identify mothers at risk for mechanical complications of labor like obstructed labor need to be conducted to identify mothers at risk for this peripartum complication so that limited resources can be focused on the provision of peripartum care to these groups to effect reduction in perinatal mortality. (Ethiopian Journal of Health Development, 2000, 14(3): 335-344)