Perinatal Mortality At The Close Of The 21st Century In Lagos University Teaching Hospital

Objective: To determine the perinatal mortality rate in Lagos University Teaching Hospital at the close of the 20th century.

Materials and Methods: Routinely collected data from the Departments of Obstetrics & Gynaecology and Paediatrics from January 1996 to December 2000, were analysed. The data included total deliveries, stillbirths and early neonatal deaths.

Results: A total of 6,759 deliveries, including 163 multiple pregnancies, occurred during the period. There were 573 perinatal deaths comprising 471(69.7/1000) stillbirths and 102(16.2/ 1000) early neonatal deaths. Autopsy was performed on 115 of the 573 deaths resulting in a perinatal autopsy rate of 20.1 percent. The overall perinatal mortality rate was 84.8/1000 while the perinatal mortality rate for singletons was 83/1000. Analysis of the deaths by the Wigglesworth classification showed that 46.6 percent of the deaths were normally formed macerated stillbirths, 38.7 percent were due to asphyxial conditions and 8.9 percent were attributed to conditions associated with immaturity. Lethal congenital malformations accounted for 3.7 percent while other specific conditions were responsible for 2.1 percent of the deaths.

Conclusion: These rates are still very high and strategies to decrease perinatal mortality will need to focus on antenatal and intrapartum obstetric care. All those involved in obstetric and neonatal care require regular education on the need for prompt identification of problems, early referral and prompt intervention.