A
PROSPECTIVE STUDY OF PERINATAL MORTALITY AT WAD MEDANI TEACHING HOSPITAL FOR
OBSTETRIC AND GYNAECOLOGY
MD Student in Obstetrics and Gynaecology
U. of G. Batch (3)
Objectives:
The aim of the present study was to calculate the perinatal mortality rate at Wad Medani Teaching Hospital for Obstetrics and Gynaecology, to investigate the principal causes of perinatal deaths and maternal and perinatal risk factors.
Methods:
A prospective case controlled study of perinatal mortality during 3 months from December 2002 – February 2003 was carried at Wad Medani Teaching Hospital for Obstetrics and Gynaecology, Sudan.
The study population comprised all deliveries and babies born at Obstetrical and Gynaecological Teaching Hospital during the period mentioned above. All data of stillbirth (gestational age > 28 weeks), early neonatal deaths and their mothers were collected and recorded prospectively. These include mother age, residence, education of the mothers, education of the husbands, income of the family per month, parity, ante-natal care, maternal diseases associated with pregnancy, mode of delivery and outcome of pregnancy. The infant’s gestational age, Apgar score at one minute, birth weight, sex and the cause of death were recorded.
In this study perinatal deaths included still birth and newborn > 28 weeks’ gestation who died within the first week of life (early neonatal deaths). Mothers who had perinatal deaths were used as cases and those with alive babies were the controls. The statistical analysis done utilize the Chi-square test with P < 0.05 considered significant.
Results:
There were 854 consecutive deliveries during the study period, 103 were perinatal deaths and 751 were alive babies, generating a perinatal mortality rate of 120 per 1000 births.
The main risk factors were; the education of the mothers (P = 0.018), education of the husbands (P = 0.002), income of the family per month (P = 0.013), antenatal care (P = 0.000), parity (P = 0.000), gestational age (P = 0.000), maternal diseases (P = 0.000), mode of delivery (P = 0.000), Apgar score at one minute (P = 0.000) and birth weight (P = 0.000) were significant risk factors.
Age (P = 0.140), residence (P = 0.591), twins - singleton (P = 0.576) and sex (P = 0.841) were not significant risk factors.
The main causes of perinatal deaths – Wigglesworth classification – were macerated still birth 36 (35%), intrapartum asphyxia 33 (32%), prematurity 21 (20.4%), congenital malformation 9 (8,7%) and other causes were 4 (3.9%).
Conclusion:
The perinatal
mortality rate is high, but it is comparable with that of the developing
countries. It is hoped that the improvement in ante-natal care, delivery care
and neonatal care will reduce the perinatal mortality rate.
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