Unearthing the Hidden Tragedy: Stillbirths in Abakaliki, Nigeria – Prevalence and Causes

Abstract

Background: Stillbirths are very traumatic events to the parents, family, and obstetricians. Although a global public health crises, it has remained relatively hidden while their devastations continue unabated in different parts of the world. We have not evaluated this tragedy in our practice environment hence the need for this paper.

Methods: This is a retrospective study involving all cases of stillbirths that occurred at the Alex Ekwueme  Federal University Teaching Hospital, Abakaliki, over a 3‑year period, 2017–2019. The case notes were gotten and relevant information was retrieved and analyzed.

Results: The prevalence of stillbirths in our centre was 16.1 per 1000 deliveries or one stillbirth in 62 deliveries. Majority of our parturients who had stillbirths 89 (81.7%) were unbooked, 43 (39.5%) had only primary  education, 16 (14.7%) had no education at all, and only 10 (9.2%) had tertiary education. The leading cause of stillbirths was abruptio placenta 27 (24.8%) followed by prolonged obstructed labor 22 (21.1%), intrauterine fetal death of unknown cause 18 (16.5%), and ruptured uterus 10 (9%). Seventy‑three (67%) women were delivered by spontaneous vaginal delivery while 18 (16.5%) had a caesarean section. Thirty (27.5%) women had postpartum hemorrhage. None of the dead babies had an autopsy performed on them.

Conclusion: The prevalence of stillbirth in our centre is unacceptably high and majority of the causes are  preventable. There is an urgent need for public enlightenment to highlight this silent tragedy and mobilize  efforts toward its prevention. Carrying out autopsies on stillbirths especially those with unexplained causes will help elucidate some of the causes.