Epidemiological Profile of Perinatal Mortality at a Tertiary Care Center in Eastern Nepal

Abstract

Introduction: Perinatal mortality is a devastating pregnancy outcome affecting millions of families in many low and middle-income countries including Nepal. This is an important indicator of the quality of obstetric care. This study examined the epidemiological profile of perinatal mortality in a tertiary care center of Eastern Nepal. Objective: The objective of this study was to know the socio- demographic profile of the perinatal death. Materials and Methods: This is a prospective descriptive study. It was conducted in a tertiary care center of Eastern Nepal from July 2017 to June 2018. There were total of 278 perinatal death recorded in this period. All the fetal death after 22 weeks of gestation to 7th day of neonatal life were enrolled. Results: Total number of obstetrics admission during the study was 12265. Total deliveries were 10564. Perinatal mortality rate was 26.31 per 1000 births, with predominance of Janajati ethnic group along with Terai geographical location: mothers age between 20- 35 years of age, nulliparity, unbooked antenatal care and gestational age less than 34 weeks. Almost 50% had presented with antepartum fetal death. The most common cause of stillbirth has been unexplained causes whereas prematurity was commonest neonatal death. Conclusion: Perinatal mortality is a hurtful pregnancy outcome which serve as an important indicator of quality of health care services of the country. Various epidemiological aspects are associated with perinatal mortality. In this study most of the perinatal deaths were unexplained followed by intrapartum hypoxia. The reason for unexplained deaths could be attributed to inadequate antenatal care while that for intrapartum hypoxia may be because of improper fetal monitoring during labor. Therefore, to prevent such events in future it is imperative that all women should get adequate antenatal care and guidelines for proper fetal monitoring should be emphasized. However, the results may not be representative of the whole population as this is a single center study. Other large scale studies are needed in future.