RESUMO
Out of the 223 fetal and neonatal deaths that occurred on the island of Curaçao in a 2-year period (1984-1985), 35 were due to birth asphyxia (15.7%). In order to evaluate the quality of obstetric care, the circumstances surrounding each asphyxiated death were scrutinized. On the whole, patients' compliance with antenatal care was satisfactory. However, when the woman presented in labor the attending physician or midwife often lacked information on maternal antecedents and the course of pregnancy. Inadequate intrapartum surveillance together with failure to respond appropriately to abnormalities in labor constituted the principle factors which were associated with asphyxiated deaths. In addition, asphyxial conditions during labor were often preceded by inappropriate administration of oxytocic agents.
Assuntos
Asfixia Neonatal/mortalidade , Cuidado Pré-Natal , Adolescente , Adulto , Feminino , Morte Fetal/prevenção & controle , Humanos , Recém-Nascido , Trabalho de Parto/efeitos dos fármacos , Prontuários Médicos , Antilhas Holandesas , Ocitócicos/efeitos adversos , GravidezRESUMO
In Curaçao a systematic and comprehensive investigation of numerous factors, potentially associated with an increased risk of foetal and neonatal mortality, was carried out in a 2-year period (1984-85). The inquiry was restricted to singleton births. Data on 205 women who experienced pregnancy loss were compared with those on 913 women who did not sustain foetal or neonatal loss. Data comprised information on maternal characteristics, clinical course of pregnancy and delivery, and neonatal characteristics. Of 130 factors measured, 14 were entered into a multivariate analysis. From the analysis 5 risk factors emerged as significant predictors of mortality: gestational age, birth weight, sex, foetal presentation and congenital anomalies. Factors such as social class, marital status, maternal age and parity were not associated with an increased risk of foetal and neonatal mortality in Curaçao.
Assuntos
Morte Fetal/epidemiologia , Mortalidade Infantil , Adulto , Análise de Variância , Parto Obstétrico , Feminino , Humanos , Recém-Nascido , Estilo de Vida , Gravidez , Fatores de Risco , Fatores Socioeconômicos , Índias OcidentaisRESUMO
A detailed clinicopathological analysis of 223 consecutive fetal and neonatal deaths was carried out in Curaçao during 1984 and 1985; this included careful histological examination of 210 infants (94%). The crude death rate was 34.2 per 1000 total births. Malformation was the principal cause of death in 28 cases, antepartum haemorrhage in 19, hypertension in 25, and asphyxia in 35. Death was caused by problems of preterm birth in 68 cases. No specific cause could be found for 34 deaths. Improvement in the quality of obstetric care might substantially reduce both fetal and neonatal death rates.