Perinatal mortality contributors in singleton gestation

ABSTRACT

To determine the feto-maternal factors contributing to perinatal mortality [PNM] in singleton gestation. Descriptive study. Gynae Unit-III, Civil Hospital, Karachi, from January to December 2002. All obstetric patients with singleton pregnancy and gestation age greater than 24 weeks, regardless of age, parity and gravidity attending the gynae unit III in labor room and ward were recruited. Patients with gestational age less than 24 weeks or multiple pregnancy were excluded. Relevant data regarding history, risk factors in mother and baby were recorded on a pre-designed proforma and later analyzed on SPSS 10 for descriptive statistics and comparison of proportions using chi-square statistics. Neonatal death was defined as live born infant who died before 28 days of age. Still birth encompassed any death of a fetus after 20 weeks of gestation or 500 gms, and perinatal mortality was considered as the sum of the still birth and neonatal death. In the 1505 studied mothers, the perinatal loss was 187[12.43%] including 140 still births and 47 neonatal deaths [3.12%]. Perinatal mortality rate [PNMR] was 124/1000 total live births and neonatal death rate [NNDR] was 34/1000 live births. The commonest cause of still birth was antepartum hemorrhage [33.5%] and the commonest cause of NND was birth asphyxia [64%]. PNM in relation to neonatal birth weight was highest in the 2.5 - 3.5 kg range i.e. 70 [50%, p=0.86]. The proportion of primi/multi parity was 60 [45%] and 23 [49%] in still birth and neonatal deaths respectively [p=0.308]. The leading causes of prematurity were antepartum hemorrhage, hypertensive disorders and chorioamnionitis. Perinatal mortality is markedly affected by fetal maturity. Parity and fetal weight have an insignificant effect on perinatal mortality