Birth asphyxia versus the quality of obstetric care in Curacao - abstract

ABSTRACT

In order to evaluate the quality of obstetric care in Curacao, a systematic and comprehensive investigation of foetal and neonatal deaths was carried out in the 2-year period, 1984-1985. Two hundred and twenty-three (223) consecutive foetal and neonatal deaths occurred in the Island during this period. Asphyxia during labour was the principal cause of death in 35 (15.7 per cent) cases most of which occurred in term infants (25/35, 71 per cent). Intrapartum death occurred in 25 (71 per cent) cases and 10 (29 per cent) infants died in the early neonatal period. On the whole, patients' compliance with antenatal care was satisfactory. However, when the woman presented in labour, the attending physician or midwife often lacked information on the antecedents of the mother and pregnancy. In addition, inadequate intrapartum surveillance together with failure to respond appropriately to abnormalities in labour constituted the main factors which were associated with asphyxiated deaths. Moreover, asphyxial conditions were often preceded by inappropriate administration of oxytocin agents. On the basis of these findings, it is recommended to identify more clearly women whose pregnancies are considered to be at medium or high risk, to improve intrapartum surveillance and to reappraise criteria for referral to the hospital classified as level 2 (secondary care) (AU)