Obstetric Diagnosis and Perinatal Mortality

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Abstract
A multidisciplinary team composed of obstetricians, pediatricians, and pathologists examined the causes of 453 consecutive perinatal deaths, which occurred between 1978 to 1982. A clear distinction between obstetric diagnosis and infant cause of death was made, and a principal obstetric and infant diagnosis was assigned to each death. Perinatal death rates by obstetric category were calculated. The rates varied from 6.1 per 1000 births in uncomplicated cases to 217.4 per 1000 births in isolated intrauterine growth retardation. The causes of perinatal death within obstetric categories were tabulated. Nonviability or the complications of prematurity (65%) were the leading causes of death when there was third-trimester bleeding, premature labor, or premature rupture of membranes. Anoxia (59%) was the most frequent cause of death when there was hypertension/pre-eclampsia or other uteroplacental insufficiency states. Death from congenital abnormality accounted for 17.7% of all perinatal deaths. A focus on the causes of perinatal death with obstetric diagnostic categories helps weigh the risk of prematurity versus the risk of anoxia in the management of high-risk gravidas.

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