ESTIMATION OF PERINATAL MORTALITY AT A TERTIARY CENTRE AND MATERNAL FACTORS CONTRIBUTING TO PERINATAL MORTALITY–A PROSPECTIVE STUDY

Rajeswary Pillay; Banisha KP

Volume : VII, Issue : I, January - 2018

ESTIMATION OF PERINATAL MORTALITY AT A TERTIARY CENTRE AND MATERNAL FACTORS CONTRIBUTING TO PERINATAL MORTALITY–A PROSPECTIVE STUDY

Rajeswary Pillay, Banisha Kp

Abstract :

Perinatal mortality is an index of efficacy of antenatal, intrapartum care and reflects socioeconomic condition of the community.

More than 5 million perinatal deaths occur globally, majority in the so called developing countries including India. Reducing preventable stillbirths and neonatal deaths continue to be a part of International Public Health agenda in the coming future.

This hospital based study was undertaken to know the causes of perinatal mortality and identify the preventable causes.

AIM:

To estimate the perinatal mortality at a tertiary health centre and maternal factors contributing to perinatal mortality.

To identify the preventable causes of perinatal mortality and offer valid solutions to reduce the incidence of perinatal mortality.

METHODS:

Women delivering at IMCH, Government Medical College, Kozhikode , with birth weight of > 500gm /gestational age > 22 weeks over a period of 1 year (Jan 2015–Dec 2015) were included in the study. Death of all fetuses weighing 500gm or more at birth or within first week of neonatal period is taken as perinatal death.

Data collected included maternal age, parity, religion, socioeconomic status, education level, gestational age, antenatal care received by woman, antenatal, intrapartum complications, mode of delivery, obstetric outcome.

RESULTS:

Perinatal mortality rate in present study is 33.5/1000 live births. Still birth rate is 20.3/1000, neonatal mortality rate is 13.6/1000, and corrected perinatal mortality rate is 15.6/1000. Perinatal mortality rate is higher in extremes of age, optimal age group for good obstetric outcome is 20–30 years. Prematurity and low birth weight babies constituted 94.2% of perinatal deaths. Other major risk factors were Preeclampsia (26.2), Gestational diabetes(22.7%), Auption (7.6%) and Anemia. Birth asphyxia contributed to 13% of neonatal deaths. Vaginal eech delivery had higher mortality rates. Congenital anomalies accounted for 11.7% of all perinatal deaths.

CONCLUSION:

Perinatal mortality is akin to the iceberg tip where much of the real issues affecting the neonate is hidden and only a part is visible. Neonatal morbidity, persistence of poor health of baby is continued into childhood and is manifested later in adult years as a poor performance individual. To ensure birth of a healthy baby, it is essential to ensure a healthy woman who is physically and mentally fit to carry her pregnancy to deliver a healthy baby. This is possible only with improved female education, accessible antenatal care, early identification of adverse antepartum conditions as preeclampsia, close monitoring of high risk pregnancies, prompt referral to centres with improved neonatal facilities.