Abstract

Introduction: A perinatal death is a fetal death (stillbirth) or an early neonatal death. Mortality rates in the perinatal period are used to evaluate the outcome of pregnancy and monitor the quality of perinatal (prenatal and neonatal) care. The perinatal mortality rate encompasses late fetal and early neonatal mortality.

Methodology: This cross-sectional investigation was completed in the Department of Obstetrics and Gynecology, Chittagong Medical College Hospital, Chittagong over a period a 6 months to watch the extent of perinatal mortality in a tertiary healing facility and the elements impacting this demise. Still-birth children and neonates’ death in first 7 day of delivery were the study population. Perinatal passing with birth weight underneath 1 kg, known gestational age beneath 28 weeks and intrauterine fetal demise (IUD) with maceration were prohibited from the investigation. A sum of 100 subjects meeting the above qualification criteria were continuously incorporated into the study. Illustrative measurements were utilized to break down the information.

Results: The findings derived from data analysis showed that the mean age of the mothers was 25.2 ± 5.1 years and the lowest and highest ages were 20 and 40 years respectively. Anemia was observed to be the most significant risk factors (90%). Physiological anemia is common in pregnancy due to haemodilution which has been evident as mild anemia in our study (72%). Then follows obstructed labor (36%), oedema (35%), hypertension (20%), preeclampsia/ eclampsia (13%), choriamnionitis (11%), abruption placentae (7%), postdated pregnancy (6%), per vaginal bleeding (5%), PROM (5%), placenta previa (3%), gestational diabetes (2%) and multiple pregnancy (2%). In terms of foetal and neonatal abnormality 28% had birth asphyxia, 40% had low birth weight, 6% IUGR and 2% congenital anomaly. 70% of the mothers had mild anemia, 8% moderate anemia, 16% severe anemia and 60% of the mothers did not have any oedema. Of the rest, 24% had mild oedema, 6% moderate oedema and 10% severe oedema. 26% of the mother had systolic blood pressure > 140 mm Hg and 18% had diastolic blood pressure > 90 mm Hg. Type of perinatal death demonstrates that 68% of patients had still birth and 32% early neonatal death. 

Conclusion: Death of babies due to birth asphyxia reflects the poor status of perinatal care, while low birth weight reflects the poor nutritional status of mothers during pregnancy. In Bangladesh, particularly in rural areas, the nature and quality of labor, delivery and post-partum practices remain relatively undocumented. Thus obstetric causes of perinatal death in rural community warrant further research.

Keywords: Perinatal mortality, foetal and neonatal factors, labor, anemia, odema, stillbirth, gestational age.