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Perinatal audit on avoidable mortality in a Dutch rural region: a retrospective study
P A De Reu1, J G Nijhuis, H P Oosterbaan
1Verloskundig Centrum Midden Brabant, Boxtel Nijmegen University, The Netherlands.
European Journal of Obstetrics, Gynecology, and Reproductive Biology
|February 5, 2000
Summary
Perinatal mortality analysis revealed that 31.5% of deaths were avoidable, with intra-uterine growth retardation and congenital malformations being key factors. Improving perinatal care is crucial for reducing these preventable infant deaths.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Medicine
- Public Health
Background:
- Perinatal mortality remains a significant concern in maternal and child health.
- Understanding the causes and preventability of perinatal deaths is essential for improving healthcare outcomes.
Purpose of the Study:
- To analyze the mode and cause of perinatal mortality in a rural Dutch region.
- To identify factors contributing to perinatal deaths and assess their avoidability across different levels of care.
Main Methods:
- A two-year prospective study (1994-1995) in the 's Hertogenbosch region.
- Perinatal audit group used an "intention to treat" and consensus model to classify causes of death.
- Analysis of responsibility for patient care at the time of death or inevitability.
Main Results:
- Out of 8509 newborns, 73 (8.58 promille) died perinatally.
- 23 cases (31.50%) were classified as probably or possibly avoidable.
- Avoidable deaths were highest in secondary care (obstetricians) at 44.86%.
Conclusions:
- Approximately 31.5% of perinatal mortality in this cohort was deemed avoidable.
- Intra-uterine growth retardation, congenital malformations, and antepartum hemorrhage were primary determinants.
- The Dutch obstetrical care system, including home deliveries, did not significantly impact the perinatal mortality rate.