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The Influence of In‐Utero Transfer on Perinatal Mortality in a Tertiary Care Centre
Author(s) -
Wittekind Carola A.,
Arnold John D.,
Leslie Garth I.
Publication year - 1989
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/j.1479-828x.1989.tb01772.x
Subject(s) - medicine , perinatal mortality , tertiary care , population , pediatrics , obstetrics , infant mortality , obstetrics and gynaecology , mortality rate , pregnancy , in utero , prenatal care , fetus , emergency medicine , surgery , genetics , environmental health , biology
EDITORIAL COMMENT: It is often questioned at State Stillbirth and Neonatal Death Committees if deaths with avoidable factors occurred in country, peripheral or tertiary centres, and whether or not the attending practitioner was a general practitioner, specialist in training, or consultant obstetrician. This paper analyses the proportion of perinatal deaths in a tertiary centre occurring in nonbooked patients — i.e. in utero transfers expectedly these patients had a high perinatal mortality rate (152 per 1,000 livebirths), and in this study accounted for 39% of all perinatal deaths. In this study the perinatal mortality for booked patients was 10.8 per 1,000 births which was less than the overall State result although the hospital population would presumably have included a relatively high proportion of high risk pregnancies. These results are excellent and important e.g. for comparison, at the Mercy Maternity Hospital, Melbourne for the triennium 1984–1986 the perinatal mortality in 15,150 booked patients was 13.3 per 1,000; there were 508 nonbooked patients (3.2%) and they provided 30.6% (90 of 294) of all perinatal deaths. Perinatal deaths may have avoidable factors due to problems in management performed in teaching hospitals and this can occur in booked or nonbooked patients. Therefore scrutiny of the causes of perinatal death is essential in both booked and nonbooked cases although the latter, largely because of prematurity, will be associated with very high mortality rates. Summary: From March 1, 1986 through February 28, 1989 inclusive there was a total of 8,319 births with a birth‐weight of 500 g or more at Royal North Shore Hospital (RNS). Three hundred and sixty one births (4.3%) resulted from in‐utero transfer of high risk pregnancies (IUT); the remainder were booked at RNS. There were 141 perinatal deaths of which 55 (39%) occurred in infants transferred in‐utero.