A Perinatal Mortality Audit of a Tertiary Care Hospital

Swati Kanchan, Muralidhar Pai, Radhika Agrawal, Nehal Machado, Keerti Kyalakond

Abstract

Background: Perinatal mortality rate (PMR) is a key epidemiologic measure of a country’s position in terms of maternal and neonatal health care.

Aim: To analyze the trends of perinatal morbidity and mortality in a tertiary care hospital

Materials and Methods: This was a retrospective study conducted at a tertiary care hospital. Medical records of 4177 deliveries conducted at the hospital between January 2019 and June 2020 were reviewed, and the neonatal outcomes and the causes of the outcomes were noted. The data were statistically analyzed.

Results: PMR was found to be 23.9%. The most significant antenatal cause was fetal growth restriction (37%), and it accounted for > 50% of perinatal mortality. Acute events (70%) in the intrapartum phase, prematurity (46.8%), and low birth weight (LBW) were found to be the leading causes of perinatal mortality. Prematurity accounted for 45.3% of neonatal mortality. Maternal morbidity was the cause of stillbirths in 40.6% of the cases. Sepsis led to neonatal mortality in 20.31% of the cases.

Maternal health significantly affected perinatal morbidity and mortality, especially in conditions such as pregnancy-induced hypertension and gestational diabetes mellitus. Acute events in the intrapartum phase, prematurity, and LBW were the major causes of perinatal mortality.

Conclusion: Improving perinatal outcome requires close monitoring of high-risk women and administering timely interventions. Timely referral to a tertiary care center with advanced life support for the neonate can help improve neonatal outcomes. Additionally, improving maternal and neonatal health care can be achieved by ensuring adequate antenatal care and intrauterine monitoring, providing nutritional supplementation, ensuring that the delivery is conducted by a professional, and promoting the concept of “a small family is a happy family”.