Fauzia Butt, Nazish Razzaq.
Perinatal mortality audit at Sharif Medical and Dental College Lahore - Pakistan.
Biomedica Jan ;28(1):40-5.

Introduction: Perinatal mortality rate (PNMR) is an indicator of quality of health in a system. It is multifactorial in aetiology and is significantly influenced by the provision of health care services. Pakistan is among the countries with highest PNMR so major efforts are needed to reduce perinatal mortality in this region. The objective of this study was to determine the perinatal mortality rate, to identify major causes responsible for these mortalities, and to suggest possible preventive measures. This is a descriptive cross sectional survey. It was carried out in the department of Obstetrics and Gynaecology, Sharif Medical City Hospital, from Jan, 2008 to Jan, 2009. Patients and Methods: A prospective review of all perinatal deaths that occurred between 28 weeks of gestation and 1st 7 days of neonatal period during one year period was recorded. Babies born before 28 weeks, delivered outside Sharif Medical City Hospital, and weighing less than 1kg were excluded. Perinatal deaths were analysed according to maternal and fetal characteristics and cause of death determined according to Aberdeen classification. Outcome measures include stillbirth rate, early neonatal death rate, and perinatal mortality rate. Results: During one year period, total births were 1116, out of which 48 were perinatal deaths, 58.33%, (95% CI 44.38-72.28) were stillbirths, and 41.67% (95% CI 27.72-55.62) were early neonatal deaths. Still birth rate was 25.08/1000 total births, and early neonatal death rate was 18.38/ 1000 live births. Perinatal mortality rate was 43/ 1000 total births. Maternal hypertensive disorders were responsible for maximum still births 22.92% (95% CI 11.03-34.81). Early neonatal deaths due to infections were responsible for 25% deaths (95% CI 12.75-37.25) primarily due to prematurity. Conclusion: Maternal hypertension, congenital anomalies and neonatal infections still remains major causes for perinatal mortality. Regular perinatal death audits and adequate provision of health care services in a given system will reduce the prevalence of these disorders.

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