Abstract

Introduction

Developing countries represent 98% of estimated 3.3 million stillbirths, which occur annually. While many developed countries have stillbirth rates as low as 3–5 per thousand births, most developing countries have rates that are ten-fold higher¹. Reductions in stillbirth rates in developed countries are primarily due to the reductions in intrapartum stillbirth rates. Increased access to obstetric services -including better intrapartum fetal-monitoring - and to cesarean sections appear to be associated with these decrease in stillbirth.

In developing countries, the causes of stillbirth, generally similar across regions, include maternal infection, fetal asphyxia, trauma, congenital abnormalities, feto-maternal hemorrhage², and a variety of medical conditions of the mother. Because there is no standard international system for defining stillbirth, comparisons over time and between geographic areas is problematic and, even using the available classification systems, the cause of most stillbirths remains unknown.

Still birth is an unacceptable event for expecting mother as well as obstetrician. Both the woman and obstetrician become desperate to know the cause of IUFD and means to prevent it in future.

The birth of a newborn after 28 completed weeks of gestation weighing 1000 gm or more, with baby showing no signs of life after delivery defines late fetal death while birth of a newborn after 22 to 28 completed weeks of gestation with baby weighing 500- 1000 gm with no signs of life after delivery defines early fetal death³. It includes both antepartum and intrapartum death. Stillbirth are the largest contributor to perinatal mortality. Of the estimated 3 million ⁴ stillbirths which occur yearly, the vast majority are in developing countries, with rates in many developing countries 10 fold higher. Despite the large no. of stillbirths worldwide, it has received very little research, programmatic or policy attention. It is emotionally upsetting to parents who are now anxious about the chances of having a pregnancy to carry through successfully in the next confinement^5,6. The study is an endeavour to assess and analyse the causes of stillbirth at a tertiary care centre.