An audit of perinatal mortality

Area of Science:

• Obstetrics and Gynecology
• Neonatal Medicine
• Public Health

Background:

• Perinatal mortality rates serve as a critical indicator of maternity care quality in Western countries.
• Understanding the causes of fetal and early neonatal deaths is essential for improving obstetric and neonatal outcomes.

Purpose of the Study:

• To conduct a 6-year prospective perinatal audit at a tertiary hospital.
• To determine fetal outcomes and identify common causes of fetal and early neonatal mortality.

Main Methods:

• Prospective audit of perinatal deaths over a 6-year period.
• Analysis of 30,987 total births, including stillbirths and early neonatal deaths.
• Categorization of mortality causes for both fetal and neonatal periods.

Main Results:

• A perinatal mortality rate of 27.7 per 1000 total births was recorded.
• Leading causes of stillbirths included hypertensive disorders of pregnancy, abruptio placentae, diabetes mellitus, intrapartum fetal distress, and congenital anomalies.
• Major causes of neonatal deaths were respiratory distress syndrome (57.8%), birth asphyxia (22.2%), and sepsis (13.5%).

Conclusions:

• Recommendations include a dedicated medical team with a neonatologist for pre-eclampsia management.
• Increased senior obstetric involvement in labor ward management is advised.
• Targeted interventions addressing identified causes could reduce perinatal mortality.