A STUDY TO EVALUATE CAUSES AND RISK FACTORS OF STILL BIRTHS IN A TERTIARY CARE HOSPITAL
Keywords:
Still birth, Hypertension, FGR, Prematurity, Recode, Intrauterine deathAbstract
INTRODUCTION: The ICD 10 defines foetal death as death prior to complete expulsion of foetus from its mother irrespective of gestational age. But WHO defines still births as baby born with no signs of life at or after 28 weeks of gestation or if weight is >1000 gm when gestation age is not available. The still births are a major contributor to perinatal mortality. So, to reduce the perinatal mortality, reduction of still births is necessary and for this better understanding of aetiology of still births is important.
MATERIAL AND METHODS A prospective study was done in the Department of Obstetrics and Gynaecology in collaboration with the Department of Pathology at Government Medical College and Rajindra Hospital Patiala during 2021-22. Review of antenatal records; maternal investigations was done and delivered foetuses were examined after delivery. For every case proforma was filled and the cause of still birth was identified and classified under ReCoDe system of still birth classification.
RESULTS: In our study, still birth rate was 40.54/1000 live births. According to ReCoDe classification, maternal causes were observed in 53/227 (23.34%), foetal cause in 38/227 (16.74%) and placental and cord origin were suspected in 50/227 (22.02%) and 6/227 (2.64%) cases respectively and Amniotic fluid in 11 cases (4.84%). In 21/227 (9.25%) cases the reason for still birth was unknown and unclassifiable. Hypertension was seen to be the most common cause 44/227 (19.38%) among maternal causes. Among the foetal causes FGR was most common 37/227 (16.29%) followed by extreme prematurity 36/227 (15.85%)
CONCLUSION: A significant proportion of still births is preventable by adequate and quality antenatal care.
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