Perinatal mortality at the Mount Hope women's hospital the first nine years, 1981-1989

ABSTRACT

The objectives of this retrospective study were to document mortality rates for early and late neonatal deaths (NND) and stillbirths (SB) and determine the frequency of major maternal conditions and neonatal problems in perinatal deaths at the Mount Hope Maternity Hospital (MHWH) from January 1981 to December 1989. Sources of data were the Medical Records Department, birth register, death register of the MHWH and the admittance register of the Neonatal Unit. Of 52,473 births, there were 736 SBs, 711 NNDs for a total of 1,447 perinatal deaths. The overall SB rate was 14.0/1,000 births, the neonatal mortality rate (NNMR) was 13.7/1,000 live births, and the perinatal mortality rate (PNMR) was 27.5/1,000 births. 73.5 percent of NNDs occurred in babies < 37 weeks gestation and 65 percent of NNDs occurred in the first 48 hours after birth. In babies <1,000g, 12 percent survived, o1,000g to <1,500g, 51.2 percent survived, o1,500g to <2,000g, 80.5 percent survived and in those o2,000g 98.7 percent survived. The commonest clinical problems in women with perinatal death were preterm labour (35.4 percent), intrauterine death (18.5 percent) and hypertensive disorders (17.3 percent). Respiratory distress from all causes was present in all NNDs, immaturity, 60.2 percent, and asphyxia and trauma in 50.9 percent of NNDs. Perinatal deaths classified according to Wigglesworth (10) identified intrapartum asphyxia (30.9), antepartum SB (25.6 percent) and conditions associated with immaturity (29.6) as problem areas to be addressed(AU)