CAUSES OF PERINATAL MORTALITY EXCESS IN PROLONGED GESTATIONS

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Abstract
The study sought to determine what proportion of the perinatal mortality excess associated with prolonged gestations was due to placental insufficiency. Using data from a large prospective study of pregnancy, the perinatal mortality rate was 20.9/1000 births for post-term and 11.7/1000 for term Infants. Only a quarter of the perinatal mortality rate excess in the post-term pregnancies was due to disorders related to inadequate uteroplacental perfusion, i.e., abruptio placentae, large placental infarcts and marked placental growth retardation. Twenty-six per cent of the mortality excess was due to congenital malformations, 19% to amniotic fluid Infections, 8% to Rh erythroblastosis fetalis and the remaining 22% to a variety of other disorders. The post-tsrm mortality excess due to congenital malformations was In infants who had hypoplastic adrenal glands, a well-known cause of prolonged gestation. The 4205 placentas of the post-term Infants did not show any significant Increases in those microscopic lesions that are characteristic of uteroplacental under-perfusion.