PERINATAL-MORTALITY IN TERM AND POST-TERM BIRTHS

  • 1 January 1980
    • journal article
    • research article
    • Vol. 56  (6) , 676-682
Abstract
The hospital records were reviewed of 64 infants born at or after 37 wk of amenorrhea who suffered perinatal mortality during a 3 yr period at Boston Hospital for Women [Massachusetts, USA]. The most frequent cause of death of a term or post-term infant was extrinsic perinatal hypoxia, and the 2nd most common was lethal malformation. Half the deaths of term infants occurred antepartum. Further reduction in perinatal mortality for this group may require extension of antepartum fetal monitoring techniques to all pregnancies. Intrapartum loss was rare, occurring at a rate of 0.43/1000 for infants delivered at term, and not at all among post-term infants. Massive aspiration of amniotic sac content was found frequently in antepartum and intrapartum death, and death from meconium aspiration occurred in neonates despite intrapartum monitoring and early suctioning of the pharynx and trachea. Asphyxiated term and post-term infants consistently pass meconium. Prevention of all deaths from meconium aspiration, thus, will require the prevention of asphyxia. A goal for obstetric care is that no fetus alive in utero at 37 wk of amenorrhea should subsequently die in the perinatal period, provided no lethal malformation is present.

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