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Perinatal audit using the 3‐delays model in western Tanzania
Author(s) -
Mbaruku Godfrey,
van Roosmalen Jos,
Kimondo Iluminata,
Bilango Filigona,
Bergström Staffan
Publication year - 2009
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2009.04.008
Subject(s) - medicine , tanzania , asphyxia , audit , obstetrics , cohort , perinatal mortality , pediatrics , emergency medicine , pregnancy , fetus , environmental science , management , environmental planning , biology , economics , genetics
Objective To audit intrapartum fetal and early neonatal deaths of infants weighing ≥ 2000 g in a regional hospital in western Tanzania. Methods The 3‐delays methodology was applied to a cohort of perinatal deaths from July 2002 to July 2004. Results The overall perinatal mortality rate in the hospital was 38 per 1000 live births, and in just over half of these cases the birth weight was ≥ 2000 g. The leading clinicopathologic causes of death were birth asphyxia (19.0%), prolonged or obstructed labor (18.5%), antepartum hemorrhage (11.5%), and uterine rupture (9.0%). First delays occurred in 19.0% of the cases, second delays occurred in 21.5%, and third delays occurred in 72.5%. Conclusion For women who delivered in this hospital, most of the substandard care occurred after admission to the health facility. The improvement of institutional health care may have a significant impact on the decision to attend health institutions and, thereby, reduce first delays.