title: Perinatal mortality in a tertiary obstetric institution.
abstract: At the Royal Women's Hospital, Melbourne in the 3 years 1987-1989 analysis of the records of 13,347 public patients revealed an overall perinatal wastage of 20.8 per 1,000 births. This seemingly high figure resulted from the fact that 45% of losses occurred in nonbooked and emergency admissions. Many patients were referred with major complications of pregnancy, especially gross prematurity, lethal congenital malformations and intrauterine deaths. During the 3-year period 74% of perinatal losses occurred before 33 weeks' gestation and only 10% were after 37 weeks. By comparison at a Victorian State level, 47% of perinatal deaths occurred before 33 weeks and more than 35% after 37 weeks' gestation. The major causes of perinatal wastage in both groups were similar. At the Royal Women's Hospital in the 3-year period lethal congenital abnormalities accounted for 19.1% of fetal wastage, premature labour, premature rupture of the membranes and cervical incompetence 16.2%, multiple pregnancy 14.7%, antepartum haemorrhage 14.0% and hypertensive disorders 9.7%. During the 3-year period 7.7% of hospital stillbirths were intrapartum compared to 27% for the State of Victoria. The stillbirth rate in Victoria has declined over the past decade, but to a lesser extent than the neonatal death rate. Over the 3-year period 1987-1989 the ratio of stillbirths to neonatal deaths was 3 to 2, and in 1989 there were nearly twice as many stillbirths as neonatal deaths (424 versus 240). Furthermore, 55% of stillborn infants in Victoria had birth-weights of more than 1,500 g compared to the Royal Women's Hospital figure of 36%.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Royal Women's Hospital, Carlton, Victoria.
authors.forename: J R
authors.initials: JR
authors.lastname: Fliegner
mesh_terms: D016550:Birthing Centers / Q000706:statistics & numerical data*; D003696:Delivery Rooms / Q000706:statistics & numerical data*; D005260:Female; D005313:Fetal Death / Q000453:epidemiology*; D005865:Gestational Age; D006771:Hospitals, Maternity / Q000706:statistics & numerical data*; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D009774:Obstetrics; D010360:Patient Transfer / Q000706:statistics & numerical data; D011247:Pregnancy; D011446:Prospective Studies; D014739:Victoria / Q000453:epidemiology