Perinatal Mortality Review in a Tertiary Care Hospital: Way Forward to Address SDG Health Goal 3

Authors

  • Manisha Bajracharya KIST Medical College Teaching Hospital, Imadol, Lalitpur, Nepal
  • Ang Tshering Sherpa KIST Medical College Teaching Hospital, Imadol, Lalitpur, Nepal
  • Ajay Dhakal KIST Medical College Teaching Hospital, Imadol, Lalitpur, Nepal
  • Sunita Bhandari KIST Medical College Teaching Hospital, Imadol, Lalitpur, Nepal
  • Heera Tuladhar KIST Medical College Teaching Hospital, Imadol, Lalitpur, Nepal
  • Meenu Maharjan KIST Medical College Teaching Hospital, Imadol, Lalitpur, Nepal

DOI:

https://doi.org/10.3126/mjsbh.v18i1.21738

Keywords:

Perinatal mortality, SDG3 Nepal, Perinatal Audit, PSANZ classification

Abstract

Introduction: Sustainable development goal 3 targets at ensuring healthy lives and promoting well-being for all at all ages. One of the component for achievement of this goal is improvement of maternal and child health; the indicators of which is perinatal mortality rate. The aim of this study was to evaluate the cause of perinatal death in a tertiary care medical centre, which may help to reduce the incidence of perinatal death and improve the quality of care.

Methods: A prospective study was done over a period of one year from April 2016 to March 2017. Causes of perinatal deaths based on PSANZ classification were recorded along with patients demographics and also avoidable factors were evaluated.

Results: Out of total 1275 deliveries, there were 21 perinatal deaths including three intrauterine foetal deaths, one still birth and seven early neonatal deaths. The perinatal mortality rate was 16.27 per 1000 birth. Majority of perinatal deaths (19%) occurred due to congenital anomalies followed by (14%) hypertensive disorder in pregnancy, intrapartum hypoxia (14%), unexplained causes (14%), 9.5% cord prolapse, antepartum haemorrhage (9.5%), 5% due to intrauterine growth restriction, gestational diabetes mellitus or preterm labour. Most of the mothers whose baby had perinatal deaths had ANC outside. Most of the deaths occurred in between gestational age of 37 to 41 weeks. Perinatal mortality was more in multigravida. Delay to seek health care and inadequate antenatal checkups were the most common avoidable factors.

Conclusions: Congenital anomalies and hypertensive disorders during pregnancy were the most common causes of perinatal death. Delay in health seeking behaviour was the most common avoidable factors for perinatal death. We recommend early identification of high risk pregnancy through proper antenatal screening, educating pregnant women to identify danger signs of pregnancy, creating public awareness about importance of antenatal checkups, vigilant labour monitoring for foetal distress, to reduce some categories of deaths.  

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Author Biographies

Manisha Bajracharya, KIST Medical College Teaching Hospital, Imadol, Lalitpur, Nepal

Lecturer, Department of Obstetrics and Gynaecology,

Contact: 00977-9808880816(M), 977-1-5201496(O)
Email: drmanishabajra@gmail.com / info@kistmcth.edu.np

Ang Tshering Sherpa, KIST Medical College Teaching Hospital, Imadol, Lalitpur, Nepal

Associate Professor, Department of Community Medicine

Ajay Dhakal, KIST Medical College Teaching Hospital, Imadol, Lalitpur, Nepal

Associate Professor, Department of Pediatrics

Sunita Bhandari, KIST Medical College Teaching Hospital, Imadol, Lalitpur, Nepal

Associate Professor, Department of Obstetrics and Gynaecology

Heera Tuladhar, KIST Medical College Teaching Hospital, Imadol, Lalitpur, Nepal

Professor Head of Department, Department of Obstetrics and Gynaecology,

Meenu Maharjan, KIST Medical College Teaching Hospital, Imadol, Lalitpur, Nepal

Department of Obstetrics and Gynaecology

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Published

2019-02-26

How to Cite

Bajracharya, M., Sherpa, A. T., Dhakal, A., Bhandari, S., Tuladhar, H., & Maharjan, M. (2019). Perinatal Mortality Review in a Tertiary Care Hospital: Way Forward to Address SDG Health Goal 3. Medical Journal of Shree Birendra Hospital, 18(1), 69–74. https://doi.org/10.3126/mjsbh.v18i1.21738

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Section

Original Articles