ABSTRACT
This study was conducted at Mansoura University Hospital, Mansoura, Egypt, through the period from April 1[st] 1998 to March 30[th] 1999, to evaluate the crude perinatal mortality rate at that center as an index for obstetric and neonatal care in our locality. Also, the study aimed to identify the major risk factors operative in perinatal losses. Also, we aim to reduce these losses by proper prediction, prevention and management of the underlying factors. Perinatal morality is still high in developing countries. Low birth weight, lethal anomalies, asphyxia, pregnancy complicated cases, grand multiparity and undermined general condition are the essential causes. The vast majority of the causes of perinatal mortality are preventable, and are within the scope of management by obstetricians. Prediction and prevention of preterm labour, is of great value for immediate reduction of perinatal mortality. Prediction and prevention of pre-eclampsia and eclampsia, urgent hospitalization and proper management of established cases are life saving. Obstetric management of multifoetal pregnancies represents a major obstetric challenge as regards good perinatal outcome. Grand multiparity should be considered as a disease and should be prevented by contraception. Strict control of diabetes mellitus and thorough evaluation of foetal well being can lead to favourable perinatal outcome. Proper conduct of the hospital deliveries, early referral of complicated cases, proper selection of cases for vaginal breech delivery, leads to noticeable and immediate reduction in perinatal mortality. Ultrasonographic screening for lethal congenital anomalies during early pregnancy and throughout gestation, and termination of pregnancy when justified. In addition to that: perinatal mortality rate will be reduced following improvement of socioeconomic and educational standards on long term. Proper data collection and efficient statistical records