Perinatal mortality at Frontier Hospital, Queenstown - a 6-year audit using the Perinatal Problem Identification Programme (PPIP)

Abstract

Objectives. To determine the perinatal mortality rate (PNMR), the neonatal mortality rate (NNMR), the major obstetric and neonatal causes of death, the occurrence of avoidable factors in perinatal deaths, and syphilis serology at the time of delivery at Frontier Hospital, Queenstown. Design. The study was an audit of perinatal deaths with retrospective and prospective periods. Setting. Frontier Hospital is a designated Regional Hospital in the Northern Region of the Eastern Cape, South Africa. Subjects. All perinatal deaths of infants weighing more than 499 g occurring from 1 January 1995 to
31 December 2000. Methods. A retrospective hospital records review from 1 January 1995 to 30 June 1996, and a prospective assessment of perinatal deaths from 1 July 1996 to 31 December 2000. Measures. PNMR, NNMR, causes of perinatal and neonatal death, avoidable factors, and syphilis serology. Results. The retrospective PNMR was 33/1 000 deliveries and the NNMR 7/1 000. The prospective PNMR started at 51/1 000 deliveries and the NNMR at 19/1 000. The prospective data then showed a downward trend. The
leading obstetric cause of death was unexplained stillbirths and the leading neonatal cause of death labourrelated hypoxia. Health personnel-related avoidable factors occurred frequently. Of these, intrapartum carerelated avoidable factors made the largest contribution. Syphilis serology at delivery was unknown in over 80% of deaths and declined to 56% over the 6-year period. Conclusions. Both the PNMR and the NNMR dropped during the audit period. This may have been due to the general audit and feedback process itself, as well as to specific responses to problems that were identified through the audit process.

SAJOG Vol. 13 (1) 2007: pp. 10-14