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A prospective review of perinatal mortality at Hospital Nacional Guido Valadares ( HNGV )
Author(s) -
Jayaratnam Skandarupan,
Soares Maria,
Bucens Ingrid,
Jennings Belinda,
Woods Cindy,
Shub Alexis
Publication year - 2020
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/ajo.12991
Subject(s) - medicine , etiology , perinatal asphyxia , pediatrics , prospective cohort study , asphyxia , obstetrics , infant mortality , perinatal mortality , psychological intervention , pregnancy , fetus , population , environmental health , surgery , psychiatry , biology , genetics
Background Timor‐Leste has one of the highest perinatal mortality rates in the Asia‐Pacific region. Consistent and accurate data collection improves understanding of perinatal outcomes and facilitates the development of interventions to reduce stillbirths and early neonatal deaths. Aims (1) To identify changes in the rates of stillbirth and early neonatal deaths from previous published data. (2) To determine if prospective data collection and the application of the simplified Causes Of Death and Associated Conditions ( CODAC ) classification allows better identification of perinatal deaths in Timor‐Leste. Methods A prospective audit of perinatal deaths of women delivering at Hospital Nacional Guido Valadares (HNGV) was undertaken from January to June 2016 inclusive. The hospital birth registry, maternal and neonatal records were reviewed to determine the most likely aetiology and classification of perinatal deaths using the simplified CODAC system. Results One hundred and ten stillbirths and 28 early neonatal deaths were identified. Fifty‐four percent of perinatal deaths occurred antepartum, 26% intrapartum and 20% were early neonatal deaths. Cause of death among stillbirths could not be ascertained in 40% of cases. Intrapartum asphyxia was the commonest identified aetiology of intrapartum and early neonatal deaths. Conclusion There has been limited improvement in the rate of stillbirths and early neonatal deaths at HNGV . Intrapartum hypoxia and maternal hypertensive conditions were the most common identified aetiologies highlighting areas where targeted interventions may help reduce high perinatal mortality rates. Aetiology of perinatal deaths, particularly antepartum stillbirths was difficult to discern even when well‐tested classification systems are used.