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An Investigation of the Maternal Antecedents of Perinatal Mortality in 2 Large Teaching Hospitals
Author(s) -
Forbes Kevin L.,
King James F.
Publication year - 1990
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.1990.tb03216.x
Subject(s) - medicine , perinatal mortality , obstetrics , autopsy , neonatal death , fetus , pediatrics , gestation , prenatal care , infant mortality , pregnancy , population , environmental health , pathology , genetics , biology
EDITORIAL COMMENT:We wish to endorse the conclusions in this paper, namely that perinatal deaths should be classified by antecedent clinical parameters, since strategies of prevention are then more likely to be enunciated and evaluated. Spontaneous preterm labour, fetal malformations and intrauterine growth retardation are well recognised as the 3 main causes of perinatal mortality. However, the view expressed in this paper that unexplained intrauterine death is an important category, worthy of special attention, requires emphasis, even although such deaths occur in only 1 in 1,000 pregnancies (la). We consider that for inclusion in this group there should be a maturity (36 or more weeks' gestation) or birth‐weight limit (≥ 2,500 g), since prenatal investigation is more likely to reap a reward if there is focus upon salvageable infants . Ia. Beischer N A, DeGaris C N, Unexplained Intrauterine Death near Term. Aust NZ J Obstet Gynaecol 1986; 26: 99–101 . Summary: Perinatal mortality reviews are a form of quality assurance, and the classification of perinatal mortality would be most useful if it assisted in strategies for prevention. Whilst the value of clinicopathological (autopsy) and separate neonatal classifications is recognized, the Whitfield classification, modified for Australian conditions and applied to 393 cases, clearly identified the major obstetric problems leading to perinatal death, and may therefore contribute to continuing improvement in prenatal care.