Causes of perinatal death at a Saudi maternity hospital

The time, cause and avoidability of perinatal deaths were analyzed in infants who were delivered in the main Maternity hospital in Riyadh and who represented a large proportion of all births in the city. The crude perinatal mortality rate was 39.8 per 1000 births. Of all deaths 53 percent occurred either intrapartum or within 24 hours of birth. The mortality rate in this time period was 9 times higher, and the intrapartum mortality rate 16 times higher than the corresponding Swedish rates. The causes of death were classified according to Wigglesworth. Of all deaths, 37 percent were due to asphyxial conditions in labor, 32 percent to conditions associated with preterm birth, and 17 percent to malformations. The perinatal mortality rates caused by asphyxia, preterm birth and malformations were 14.7, 12.6 and 6.7 per 1000 births, respectively. 75 percent of infants who died from asphyxia were born at term, and nearly half of the preterm deaths were associated with severe asphyxia at birth. Avoidable factors were found in 74 percent of the deaths. The high rate of asphyxia indicated deficiences in the obstetric management and a high priority should be given to the strengthening of the obstetric service.