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Background: Intrauterine fetal death (IUFD) is one of the most important problem in reproductive health, especially in developing countries. Unbooked pregnant women are more likely to suffer IUFD.
Objectives: To determine the prevalence and risk factors of intrauterine fetal death among unbooked paturients at the University of Port Harcourt Teaching Hospital.
Materials and Methods: A retrospective study of 344 unbooked women with intrauterine fetal death who presented at the labour ward of the University of Port Harcourt Teaching Hospital between January 1, 2011 and December 31, 2015. Data was obtained from their case / theater records and ward registers, encoded into a spreadsheet and analyzed using SPSS 22.0. Results were presented as means, rates and proportions. Associations between variables were assessed using students t-test and Pearson’s correlation. Differences were considered statistically significant at P < 0.05.
Results: There were 12,421 deliveries during the study period: 10,136 (81.6%) received antenatal care while 2,285 (18.4%) did not. There was a total of 1,313 perinatal deaths, giving a perinatal mortality rate of 60.9/1000 births in unbooked patients and 18.4/1000 births in booked patients (P <0.01). Majority 149 (43.3%) of the IUFD occurred below 37 weeks and 123 (35.8%) at term. IUFD occurred prior to presentation in 320 (93%), of which most were referred from traditional birth attendants and religious institutions. Hypertensive disorders, abruptio placentae, obstructed labour, prolonged pregnancy, and prolonged rupture of membranes were the most common complications associated with IUFD.
Conclusion: Pregnant women should be encouraged to register for antenatal care and deliver in health facilities with skilled attendants.
Balu D, Ashwini NU, Asha Swarup OV. A study of Intrauterine Fetal Death in a Teaching Hospital. Int J Reprod Contracept Obstet Gynecol. 2015; 4(6): 2028-2031.
Lawn JE, Blencowe H, Pattinson R, Cousens S, Kumar R, Ibiebele I, et al. Stillbirths: Where when why how to make the data count. Lancet. 2011;377:1448–1463.
Stanton C, Lawn JE, Rahman H. Stillbirth rates: Delivering estimates in 190 countries. Lancet. 2006;367:1487¬1494.
Adimora GN, Odetunde IO. Perinatal mortality in University of Nigeria Teaching Hospital (UNTH) Enugu at the end of the last millennium. Niger J Clin Pract. 2007; 10:19-23.
Federal Ministry of Health. National Demographic and Health Survey. Perinatal Mortality; 2008.
Kuti O, Orji EO, Ogunlola IO. Analysis of perinatal mortality in a Nigerian teaching hospital. J Obstet Gynaecol. 2003;23:512-514.
The Lancet Series. Ending Preventable Stillbirths; 2016.
Archibong EI, Shobande AA, Asindi AA. Antenatal intrauterine fetal death: A prospective study in the tertiary hospital in South-Western Saudi Arabia. Journal of Obstetrics and Gynaecology. 2003;23(2): 170–173.
Incerpi MH, Miller DA, Samadi R. Stillbirth Evaluation: What tests are needed? Am J Obstet Gynecol. 1998;178:1121-1125.
Faye-Petersen OM, Guinn DA, Westrom KD. Value of Perinatal Autopsy. Obstet Gynecol. 1999;94(6):915-920.
McClure EM, Nalubamba-Phiri M, Goldenberg RL. Stillbirth in developing countries. Int J Gynaecol Obstet. 2006; 94:82-90.
Obed SA. Intrauterine fetal death. In: Kwawukume EY, Emuveyan EE (editors). Comprehensive obstetrics in the tropics. 1st ed. Accra: Asante and Hittscher Printing Press Ltd. 2002;193-197.
Kambarami RA. Levels and risk factors for mortality in infants with birth weights between 500 and 1,800 grams in a developing country: a hospital-based study. Cent Afr J Med. 2002;48:133-136.
Dubowitz L M S, Dubowitz V, Goldberg C. Clinical assessment of gestational age in the Newborn Infant. J Pediatr.1970;77(1); 1-10.
Fawole AO, Shah A, Tongo O, Dara K, El-Ladan AM, Umezulike AC, et al. Determinants of perinatal mortality in Nigeria. Int J Gynaecol Obstet. 2011;114: 37-42.
Ibekwe PC, Ugboma HU, Onyire N, Muoneke U. Perinatal mortality in Nigeria; Less than half a decade to Millenium Development Goals. Ann Med Health Sci Res. 2011;1(2):215–222.
Igberase GO. Perinatal mortality in a rural referral hospital in the Niger Delta, Nigeria. Afr J Med Health Sci. 2014;13:47-50.
Fabamwo A, Akinola D, Mojoyinola O. The Tragic Consequences of unsupervised pregnancies among patients referred to a tertiary maternity unit in Lagos, South-West Nigeria. Int J Trop Med. 2010;7:9. Available:http//dx.doi.org/10.5580/23d1
Agbata AT, Eze JN, Ukaegbu CI, Odio BN. A 4-year retrospective review of stillbirth at the Federal Teaching Hospital, South-Eastern Nigeria. Afr J Med Health Sci. 2017;16:19-24.
Suleiman BM, Ibrahim HM, Abdulkarim N. Determinants of Stillbirths in Katsina, Nigeria. A Hospital-Based Study. Pediatr Rep. 2015;24:7(1):5615.
Okeudo C, Ezem BU, Ojiyi EE. Stillbirth rate in a Teaching Hospital in South-Eastern Nigeria: A silent tragedy. Ann Med Health Sci Res. 2012;2(2):176-179.
Bobzom DN, Unuigbe JA. Stillbirths and perinatal mortality at the University of Benin Teaching Hospital Nigeria. J Obstet Gynaecol. 1996;16(3):159-162.
Olusanya BO, Solanke OA. Predictors of term stillbirths in an inner-city maternity hospital in Lagos, Nigeria. Acta Obstet Gynecol Scand. 2009;88:1243–1251.
Afulani PA. Determinants of Stillbirths in Ghana: Does quality of antenatal care matter? BMC Pregnancy Childbirth. 2016; 16:132.
Emaebong A. A ten-year analysis of Intrauterine Fetal Death: An age-matched case control study at a General Hoapital in sub-Saharan Africa. Evo J Public Health 2017;2(2):12-18.
Mutihir JI, Eka PO. Stillbirths in Jos University Teaching Hospital: Incidence, risk, and etiological factors. Nig J of Clinic Pract. 2011:14(1):14-18.
Chuwa FS, Mwanamsangu AH, Brown BG, Msuya SE, Senkoro EE, Mnali OP, et al. Maternal and fetal risk factors for stillbirth in Northern Tanzania: A registry-based retrospective cohort study. PLoS ONE. 2017;12(8):e0182250
Bahtiyar MO, Funai EF, Rosenberg V, Norwitz E, Lipkind H, Buhimschi C, et al. Stillbirth at term in women of advanced maternal age in the United States: When could the antenatal testing be initiated? Am J Perinatol. 2008;25(5):301-304.