Incidence of Intrapartum-Related Events at the Largest Obstetric Hospital in Hanoi, Vietnam: A Retrospective Study

Abstract

Every year, 2.4 million neonates die during their first month of life and even more suffer permanent injury. The main causes are intrapartum-related events, prematurity, and infection, with sub-Saharan Africa and southern Asia being the worst affected regions. With a focus on intrapartum-related events, we aimed to assess the neonatal demographic characteristics, clinical management, and outcomes among neonates born at the largest obstetric hospital in Hanoi, Vietnam. This was a retrospective cross-sectional study that included all the inborn neonates in November 2019, which was selected as a representative month. A total of 4554 neonates were born during the study period. Of these, 1.0% (n = 44) were stillbirths, 0.15% (n = 7) died in hospital, 0.61% (n = 28) received positive pressure ventilation at birth, and 0.15% (n = 7) were diagnosed with hypoxic ischemic encephalopathy. A total of 581 (13%) neonates were admitted to the neonatal unit, among which the most common diagnoses were prematurity (37%, n = 217) and infection (15%, n = 89). Except for the intrapartum-related events, our findings are consistent with the previously documented data on neonatal morbidity. The intrapartum-related events, however, were surprisingly low in number even in comparison to high-income countries. Research on the current clinical practice at Phu San Hanoi Hospital may bring further clarity to identify the success factors.

Endotracheal intubation performance at a large obstetric hospital delivery room, Hanoi, Vietnam

“…Finally, this study confirms remarkably low PPV and ETI incidences at birth in this setting (0.4% and 0.2%). This is consistent with data previously reported from the Phu San Hanoi Hospital by our research team (0.6% and 0.2%) 6 . The expected PPV incidence is 3–6% and ETI incidence is 1–2% 8 , 27 .…”

“…The expected PPV incidence is 3–6% and ETI incidence is 1–2% 8 , 27 . We have previously discussed some possible explanations for our findings, including a high c-section rate (over 50% of all births, approximately half of which are emergency c-sections) and few instrumental deliveries 6 . Nonetheless, it is truly difficult to interpret our findings.…”

“…Our research team has previously reported a low rate of intrapartum-related events at Phu San Hanoi Hospital compared to global figures. In November 2019 the overall positive pressure ventilation (PPV) rate at birth was 0.6%, the incidence of hypoxic-ischemic encephalopathy was 0.15%, the stillbirth rate was 1.0%, and no term live-born neonates died due to an intrapartum-related event 5 , 6 .…”

The Influence of Maternal Factors on Neonatal Intensive Care Unit Admission and In-Hospital Mortality in Premature Newborns from Western Romania: A Population-Based Study

“…In-creased preterm births result in an increase in newborn mortality. Congenital abnormalities, delivery trauma, birth asphyxia, and hospital-acquired infection are other reasons for newborn mortality that were previously reported but not evaluated in the current study [32]. A recent national investigation showed many important risk factors, including preterm, low birth weight, mother's age under 20 years, a history of newborn mortality or stillbirth, preeclampsia, insufficient prenatal care, congenital malformations, and gestational age less than 37 weeks [33].…”