Perinatal Mortality: An Outcome of Quality of Perinatal Care

Abstract

Background: Perinatal mortality is the most sensitive index of health status of pregnant women and the quality of maternal and child health services. This study was carried out to determine the extent and determinants of perinatal mortality.

Methodology: It was an observational study carried out in Gynae B unit, Ayub Teaching Hospital Abbottabad, from January 2005 to December 2007. All perinatal deaths including stillbirths and early neonatal deaths were studied. Women delivered between 24 to 42 weeks gestation were included. Details of maternal age, booking status, parity, and social status were evaluated. Pregnancy related complications, medical disorders, labor details, and fetal conditions leading to perinatal death were taken into account.

Results: During the study period 5412 deliveries occurred. There were 498 perinatal deaths with a perinatal mortality rate of 92/1,000 live births. Among these ladies, 11.2% were booked, and 88.7% un-booked. Perinatal death rate in maternal age <20 years was 9.4%, 21-30 years 44.9%, 31-40 years 39.95% and >40 years 5.6%. There were 26.7% deaths in primipara, 42.9% in para 2-5 and 30.3% in para >5. Gestational age from 24-32 weeks was in 40.3%, 33-36 weeks 31.7% and 37-42 weeks 28.5%. Regarding deaths, 21.8% were due to antepartum hemorrhage, 20.4% hypertensive disorders of pregnancy, 18% mechanical cause, 14.4% congenital anomalies, 12.8% neonatal causes, 5% maternal medical disorders and 8.4% were unexplained.

Conclusion: Perinatal mortality is still high due to poor maternal health, lack of adequate antenatal, intranatal and postnatal care. Improvement in public awareness of health facilities, health status of potential mothers, socioeconomic status, literacy rate and adequate peripartum care can prevent large number of perinatal deaths.