Antepartum Fetal Death in a Nigerian Teaching Hospital: Aetiology and Risk Factors
AbstractContext: Antepartum fetal death is a significant contributor to perinatal mortality and challenges the adequacy of antenatal surveillance. Identifying the causes and risk factors for death may aid its prevention.
Aim: To determine the causes of antepartum fetal death and identify associated risk factors.
Subjects and Methods: All antepartum fetal deaths, with fetuses weighing 1 kg or more, delivered at Wesley Guild Hospital, Ilesa between January 1996 and December 2000 were the subjects. The controls were all live births delivered immediately before and after every index fetal death. Information on maternal demographic details, past obstetric history and antenatal complications were retrieved from the case notes of both the subjects and the controls for analysis.
Results: The total number of births during the study period was 5,050 with 266 stillbirths. Of the stillbirths, 111 (41.7%) were antepartum out of which 70 (63.1%) weighed 1 kg and above. The main causes of death were antepartum haemorrhage (20%), maternal disease (14.3%) and pre-eclampsia/eclampsia (11.4%). The cause of death was unknown in 38.8% of cases. The main risk factors identified for antepartum death were lack of antenatal care and low birthweight. Maternal age and parity did not seem to be risk factors for antepartum fetal loss.
Conclusion: Maternal disease is still a major cause of antepartum deaths in our society. Improved antenatal care and better surveillance of fetal growth may reduce the current high stillbirth rate in our society.
Key Words: Perinatal Mortality, Stillbirth, Intrauterine Death
[Trop J Obstet Gynaecol, 2003, 20: 134-136]
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