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Perinatal mortality audit in a Zimbabwean district
1Department of Gynaecology and Obstetrics, Gweru Provincial Hospital, Zimbabwe.
Abstract:
Perinatal deaths were systematically investigated over a 25-month period in a Zimbabwean district and were classified into pathological subgroups according to Wigglesworth. There were 319 perinatal deaths (a rate of 30.6 per 1000) including 83 normally formed macerated stillbirths, 28 cases of congenital malformation, 79 deaths associated with immaturity, 111 due to asphyxial conditions developing in labour and 18 specific problems. Syphilis infection was a contributory factor among 27 cases, hypertension in 39 cases, amniotic fluid infection in 31 cases and diabetes in 11 cases. An avoidable factor was detected among 242 cases (75.6%) involving the mother in 120 cases, the maternity centres in 28 and the hospital in 94. These data suggest that educational programmes should try to convince all the pregnant women to attend an antenatal clinic at least once. A further perinatal mortality reduction might be obtained through treatment for syphilis, hypertension, diabetes and amniotic fluid infection, closer monitoring of the fetal condition during labour and skillful management of dystocia.
Insights
Perinatal deaths in Zimbabwe were investigated, revealing high rates linked to avoidable factors. Interventions like antenatal care and managing infections/hypertension can reduce these tragic outcomes.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Perinatology
Background:
- Perinatal mortality remains a significant global health challenge, particularly in low-resource settings.
- Systematic investigation of perinatal deaths is crucial for identifying causes and guiding interventions.
Purpose of the Study:
- To systematically investigate and classify causes of perinatal deaths in a Zimbabwean district.
- To identify avoidable factors contributing to perinatal mortality.
- To provide evidence-based recommendations for reducing perinatal mortality.
Main Methods:
- A 25-month systematic investigation of perinatal deaths in a Zimbabwean district.
- Classification of deaths into pathological subgroups using Wigglesworth criteria.
- Analysis of contributing factors including maternal conditions, infections, and healthcare system issues.
Main Results:
- A total of 319 perinatal deaths were recorded, with a rate of 30.6 per 1000 births.
- Major causes included asphyxial conditions (111), immaturity (79), and macerated stillbirths (83).
- Avoidable factors were identified in 75.6% of cases, involving mothers, maternity centers, and hospitals.
Conclusions:
- Educational programs promoting antenatal clinic attendance are essential.
- Improved management of syphilis, hypertension, diabetes, and amniotic fluid infections can reduce mortality.
- Closer fetal monitoring during labor and skilled management of dystocia are recommended.