Optimising management of stillbirths in modern Singapore.
OBJECTIVE
To conduct a critical analysis of stillbirths in Kandang Kerbau Hospital with emphasis on epidemiological factors, related causes and investigation strategies.


METHODS
A prospective study.


METHODS
Kandang Kerbau Hospital.


METHODS
Case records containing antenatal and post-partum details of all 136 stillbirths were obtained from the medical records office and reviewed by 3 obstetricians. Epidemiological data, antenatal history, intrapartum progress, post-partum investigation, post-mortem findings (where applicable) were reviewed and recorded.


RESULTS
The incidence of stillbirths was 4.48/ 1,000 in 1994. 73.1% of the stillbirths were macerated. Significantly higher stillbirth rates were noted in the Malays and unbooked or late booking cases. The causes of stillbirths were unexplained in 29.4%. Fetal anomalies constituted 18.4%, followed by asphyxia, abruptio, and cord accidents. Maternal obstetrical problems contributed to the rest.


CONCLUSIONS
A comprehensive management strategy to reduce stillbirths include community and patient education, early or shared antenatal care, careful prenatal surveillance, optimum investigations as well as a careful audit with adequate bereavement and counselling.
Yeong
C T
CT
Department of Maternal Fetal Medicine, Kandang Kerbau Women's and Children's Hospital, Singapore.
Tan
K H
KH
Tee
C S
CS
Yeo
G S
GS
D005260:Female; D005313:Fetal Death / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011295:Prenatal Care; D011446:Prospective Studies; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology