Max Brinsmead MB BS PhDMay 2015

DefinitionThe sum of stillbirths and neonatal deaths

(in the first week of life for infants weighing >500g (WHO)

400g (developed world)1000g (suggested) or 22 weeks gestation (often not known)

Per 1,000 total births

Perinatal Mortality around the WorldRanges from

150 in parts of Africa to...<10 in developed world

A rate of >80 is regarded as “unacceptable”Apparently 40+ in PNGWas 27.9 at PMGH in 2010Is as low as 25 in some developing countries

e.g. Chile, Cuba & Costa Rica

Worldwide Causes of Perinatal Mortality IUGR stillbirthSyphilis (and a few other fetal infections)Birth asphyxia

Often due to obstructed labour Malpresentation Cord prolapse

Birth traumaSpontaneous pre term birthMaternal causes

Hypertensive disease & eclampsia APH

Prolonged pregnancyCongenital malformations

Perinatal Deaths NSW 2001-03

Congenital Malformations that Cause Perinatal Death

Prematurity as a Cause of Perinatal Death

Infections that Cause Perinatal Death

Hypertensive Causes of Perinatal Death

Obstetric Haemorrhage that Causes Perinatal Death

Maternal Diseases that Cause Perinatal Death

Hypoxic Causes of Perinatal Death

Other Causes of Perinatal Death

Causes of Neonatal Death

Perinatal Mortality & Morbidity at John Hunter Hospital

John Hunter Hospital Audit1998 Perinatal Mortality and Morbidity

Avoidable Factors

None Mother Carers System

56.4%

16.4% 24.5%

2.7%