Classification of stillbirth by relative condition at death (Re Co De) at various trimesters of pregnancy: a rural tertiary teaching hospital based study

Abstract

Background: New global health figures show India to have the highest rates of stillbirth in the world. While maternal and under 5 child mortality rates have halved, stillbirth remains a neglected global endemic. To reduce stillbirths, the prevalence, risk factors and causes must be known. The aim of the present study is to know the prevalence and classify stillbirths by ReCoDe classification system at different trimesters of pregnancy.Methods: This was a retrospective study done between January 2013 to March 2017 at MediCiti Institute of Medical Sciences, a rural tertiary teaching hospital, Telangana, India. A total of 112 cases of stillbirths were included. Data was obtained on demographic variables, risk factors such as preeclampsia, etc. Data regarding mode of delivery, fetal asphyxia, were recorded.Results: Stillbirth rate was 12.1/1000 births. Fifty four percent of the women were unbooked. Preterm stillbirths were a majority (67%). The intra-partum still birth rate was low (15.1%) contrary to what is seen in low middle-income countries. Gestational hypertension/Pre-eclampsia, abruptio placenta, fetal growth restriction and oligohydramnios were the leading causes of stillbirths.Conclusions: Pregnant women from rural background with low socio-economic status are prone for stillbirths. As stillbirths were more among unbooked cases, the study highlights the importance of counselling, creating awareness in the rural areas regarding the importance of regular antenatal checkups. Identifying risk factors like pre-eclampsia, anemia etc., at early weeks will enable us to initiate appropriate strategies to improve pregnancy outcome.

Association of Stillbirths with Maternal and Fetal Risk Factors in a Tertiary Care Hospital in South India

“…e stillbirths were more in unregistered women as compared to registered women, that is, 94 (54.97%) and 77 (45.03%) stillbirths, respectively, in the study setup. is is in concurrence to a study conducted by Rajagopal et al (unregistered stillbirths 54.4% vs. registered stillbirths 45.5%) [12]. e diagnosis and surveillance of high-risk pregnancies by skilled health personnel and prompt effective management of complications in registered gravidas can explain the low stillbirths in the registered women.…”

“…ough advanced maternal age is a known risk factor for both increased perinatal morbidity and mortality, the majority of the stillbirths (140 (82%)) were seen in the women Obstetrics and Gynecology International between the age group of 20 and 30 years, similar higher rates were seen in a study conducted by Rajagopal et al (71.4%) [12]. In India, a higher prevalence of early marriage and completion of family before 35 years of life in women can explain the higher number of births and stillbirths in this age group.…”

“…It was observed that stillbirths were more common in the primigravida (78 (45.61%)) among the study population. e [10,12,17]. e prevalence of low birth weight (<2.5 kg) including very low birth weight (1000-1499 grams) and extremely low birth weight (500-999 grams) was 143 (83.62%) collectively in the study population.…”

Does the safe childbirth checklist (SCC) program save newborn lives? Evidence from a realistic quasi-experimental study, Rajasthan, India

“…Obtaining this level of information from records and registers at the facility was not feasible, as the providers did not make this distinction while recording stillbirths. However, studies from India have reported that fresh stillbirths contribute 50 to 80% of total stillbirths [40–42] and a more recent study reported that 30% of stillbirths were attributable to obstetrics complications and excessive bleeding during delivery [43]. Finally, our study sites were the 34 facilities with SNCUs (contributing to almost 60% of total births from all study facilities), impacting the generalizability of our results across all health facilities.…”

Decoding stillbirths using the Relevant Condition at Death classification: Study from the developing world

“…Gardosi et al (3) found an incidence of hypertensive disease of only 0.8%. Ajini et al (13) found an incidence of 27.6%, and Rajagopal et al (15) found an incidence of 28%. Notably, the incidence of severe hypertensive disorders (severe pre-eclampsia/eclampsia/HELLP syndrome) among booked patients was nearly half.…”