Perinatal mortality at a level 2 obstetric hospital: problems after 32 weeks gestation

The aim of this study was to find ways to reduce perinatal mortality. At St Helens Hospital there were 9876 births in the four year period 1978-81 and 93 perinatal deaths occurred, a perinatal mortality rate of 9.42 per 1000, stillbirths 6.58 and early neonatal deaths 2.84. Since 1971 the perinatal rate has been reduced by 29%. Perinatal anoxia was the major cause of death affecting 56 (5.67 per 1000). Only one infant each died of obstetric trauma, and respiratory distress syndrome, 0.1 per 1000. Infection affected four (0.4 per 1000) and lethal congenital abnormalities 24 (2.43 per 1000). Potentially medical avoidable factors were found to have occurred in 31% of the mothers and patient avoidable factors in 6% of mainly late or unbooked mothers. Unsure or incorrect dates in many mothers increased the difficulties in the recognition of infants with intrauterine growth retardation who are at high risk of hypoxia.