Perinatal mortality at the North West Armed Forces Hospital, Tabuk, Saudi Arabia and the potential benefits of the biophysical profile score

The patterns and causes of neonatal mortality at a tertiary hospital in oman

OBJECTIVE

To report the patterns and causes of neonatal death from a tertiary care neonatal intensive care unit over a period of four years.

METHODS

This is a retrospective cohort study where four years data (January 2006 - December 2009) of all inborn neonatal admissions and deaths were collected from the neonatal intensive care unit at Sultan Qaboos University hospital on predesigned forms. All out born admissions and deaths were excluded. The causes of neonatal death were classified using Wigglesworth's classification.

RESULTS

The number of inborn live births during the study period was 10064 and the total number of inborn neonatal admissions was 1475. The total deaths (neonatal and post neonatal) at the neonatal intensive care unit was 73 (63 inborn and 10 out born). Among the inborn, five deaths were post neonatal deaths and hence, excluded from analysis. Among the remaining inborn neonatal deaths (n=58), 34 (59%) were males and 24 (41%) were females. The number of neonatal admissions increased over the years during the study period from 248 to 356, while the number of deaths also increased from 10 deaths in 2006, to 20 deaths in 2009. The primary causes of neonatal deaths were prematurity and its complications 52% (n=30). Lethal congenital malformations lead to 17 (29%) newborn deaths, specific diagnosis in 7 newborns (12%), and birth asphyxia in four (7%) of cases.

CONCLUSION

There was an increasing trend of neonatal admissions and deaths among inborn babies. Prematurity, with sepsis as its major complication and congenital malformations were the leading cause of neonatal mortality.

Biophysical profile score in late pregnancy and timing of delivery

OBJECTIVE

To determine if the Biophysical Profile Score (BPS) as a screening procedure on patients without antenatal care (unbooked patients), seen in late pregnancy, is of value in providing an insight into the mode of delivery and fetal outcome.

DESIGN

Prospective case study of pregnant mothers, data collection and analysis over 2 years at Abha Maternity Hospital, Saudi Arabia.

SUBJECTS

Unbooked patients with abnormal BPS (Group I), and patients with normal BPS (Group II) used as control subjects, delivered in the hospital from January 1996 through December 1997.

RESULTS

The number of normal deliveries was significantly higher (P < 0.01) in the control group than in the study group patients. Cesarean section rate was significantly higher in the study group than in the control group (P < 0.01, OR = 4.48). There was a significant increase in the number of asphyxiated and meconium aspirated babies in the study group than in the control group. Neonates that needed mechanical ventilation were significantly higher in the study group than in the control group (P < 0.01, OR = 10.38).

CONCLUSION

These findings suggest that abnormal BPS is invaluable in effecting delivery, particularly in women without antenatal care, who present in late pregnancy to an obstetric unit. Patients with abnormal BPS are four times more likely to be delivered by cesarean section than those with normal BPS.