Perinatal death audit and classification of stillbirths in two provinces in Papua New Guinea: A retrospective analysis.
Adult
Asphyxia Neonatorum
/ epidemiology
Breech Presentation
/ epidemiology
Cohort Studies
Female
Humans
Infant, Newborn
Papua New Guinea
Patient Acceptance of Health Care
Perinatal Death
/ etiology
Pre-Eclampsia
/ epidemiology
Pregnancy
Randomized Controlled Trials as Topic
Retrospective Studies
Stillbirth
/ epidemiology
Young Adult
avoidable factors
intrapartum asphyxia
intrapartum monitoring
pre-eclampsia
stillbirth
unexplained
Journal
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
ISSN: 1879-3479
Titre abrégé: Int J Gynaecol Obstet
Pays: United States
ID NLM: 0210174
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
pubmed:
25
10
2020
medline:
5
5
2021
entrez:
24
10
2020
Statut:
ppublish
Résumé
To undertake a retrospective perinatal death audit and assessment of avoidable factors associated with stillbirths among a cohort of women in two provinces in Papua New Guinea. We used data from an ongoing cluster-randomized crossover trial in 10 sites among 4600 women in Papua New Guinea (from 2017 to date). The overarching aim is to improve birth outcomes. All stillbirths from July 2017 to January 2020 were identified. The Perinatal Problem Identification Program was used to analyze each stillbirth and review associated avoidable factors. There were 59 stillbirths among 2558 births (23 per 1000 births); 68% (40/59) were classified "fresh" and 32% as "macerated". Perinatal cause of death was identified for 63% (37/59): 30% (11/37) were due to intrapartum asphyxia and traumatic breech birth and 19% (7/37) were the result of pre-eclampsia. At least one avoidable factor was identified for 95% (56/59) of stillbirths. Patient-associated factors included lack of response to reduced fetal movements and delay in seeking care during labor. Health personnel-associated factors included poor intrapartum care, late diagnosis of breech presentation, and prolonged second stage with no intervention. Factors associated with stillbirths in this setting could be avoided through a package of interventions at both the community and health-facility levels.
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
160-168Subventions
Organisme : Medical Research Council
ID : MR/N006089/1
Pays : United Kingdom
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : NHMRC
Informations de copyright
© 2020 International Federation of Gynecology and Obstetrics.
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