Baird-Pattinson Aetiological Classification and Phases of Delay Contributing to Stillbirths in a Nigerian Tertiary Hospital

Abstract

Purpose. This study aims to identify triggers of stillbirth in the study setting and to make suggestions to reduce the prevalence. Method. A three-year retrospective case-control study of stillbirths at Ekiti State University Teaching Hospital. Results. The stillbirth rate was 33 per 1000 births. Based on Baird-Pattinson classification of the primary obstetric causes of stillbirth, adverse intrapartum events, hypertensive diseases, and unexplained intrapartum fetal deaths were topmost causes of stillbirths. In comparison with the controls, other identified predictors of SB were grand multiparity (p = 0.016), delays in seeking medical care and/or in receiving treatment (p = 0.001), wrong initial diagnosis (p = 0.001), inadequate intrapartum monitoring (p = 0.001), and inappropriate clinical management (p = 0.001). Conclusion. Stillbirth rate remains high in our setting. Elimination of obstacles to accessing care, effective management of hypertensive disorders in pregnancy, updated health facilities, improved dedication to duty, and retraining of health workers will reduce the prevalence.

A review of socio-demographic and clinical correlates of stillbirth at a teaching hospital with limited advanced fetal surveillance

“…This relatively high stillbirth rate is probably due to the fact that EKSUTH, Ado-Ekiti is a major referral centre around Ekiti environs with high influx of highrisk and complicated obstetric cases and it is situated in basically agrarian community where there is a poor health seeking attitude among the pregnant women, poor transportation system, poor usage of antenatal care and delay in presentation when complications arise. Delays in seeking and/or accessing care were major contributing factors to stillbirth in the earlier study conducted by Awoleke and Adanikin at the same centre of study [21] . The larger proportions (56.4%) of the stillbirths were fresh stillbirths.…”

“…This finding is also in consonance with the result of the study of Olofinbiyi et al also conducted at the same institution [25] . It is documented that grand-multiparous women rarely access prenatal care because they feel overly confident of their past experience of pregnancy and, therefore, assume that no untoward event will occur [21,26] . Mothers with no or low formal (primary) education were more likely to deliver stillbirth babies (44.4% and 24.6% respectively) when compared to those with tertiary education (04.1%).…”

The burden, prevention and care of infants and children with congenital anomalies in sub-Saharan Africa: A scoping review

“…The period of survival was mainly during the first year of life, or in the days/months following surgery, with no long-term survival studies. In some studies, mortality of babies with CAs was included as part of an investigation into all causes of neonatal death (e.g., [ 29 , 150 , 264 ]). In others, mortality was reported as an outcome following implementation of a new care protocol (e.g., [ 54 ]); or as rates of termination of pregnancy for fetal anomaly following prenatal diagnosis (e.g., [ 84 , 87 ]).…”

Determinants of stillbirth among reviewed perinatal deaths in Ethiopia

“…Congenital malformation, infection, gestational age, sex, and birth weight are the fetal factors related to stillbirth ( 26 – 30 ), while maternal health conditions before and during pregnancy, maternal age, maternal parity, history of ANC visit, mode of delivery, maternal education, wealth index, birth interval, previous history of stillbirth, fetal movement monitoring are the major maternal factors ( 31 – 35 ). On the other hand, factors such as intrapartum monitoring, clinical management, and capacity of diagnosis are some of the facility-level predictors of stillbirth ( 36 ).…”