Importance of prenatal care in reducing stillbirth

Goldenberg, Renato; McClure, EM

doi:10.1111/1471-0528.14696

Cited by 11 publications

(10 citation statements)

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“…These results confirm the importance of antenatal care for identifying pregnancy complications and taking prompt action to manage the complications that increase the risk of stillbirths. As preventing stillbirths becomes a more visible goal of the maternal and child health agenda, attention to the important role of antenatal care in reducing stillbirths becomes critical [17, 18]. The results also indicate the need for steps to be taken to ensure that women are educated about the importance of delivering in health facilities rather than at home or in non-orthodox places such as in the homes of traditional birth attendants or in Churches.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and determinants of stillbirth in Nigerian referral hospitals: a multicentre study

Okonofua

Ntoimo

Ogu

et al. 2019

BMC Pregnancy Childbirth

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BackgroundIn 2015, Nigeria’s estimated 317,700 stillbirths accounted for 12.2% of the 2.6 million estimated global stillbirths. This suggests that Nigeria still makes substantial contribution to the global burden of stillbirths. This study was conducted to determine the prevalence and identify the causes and factors associated with stillbirth in eight referral hospitals in Nigeria.MethodsThis was a cross-sectional study of all deliveries over a period of 6 months in six general hospitals (4 in the south and 2 in the north), and two teaching hospitals (both in the north) in Nigeria. The study population was women delivering in the hospitals during the study period. A pre-tested study protocol was used to obtain clinical data on pregnancies, live births and stillbirths in the hospitals over a 6 months period. Data were analyzed centrally using univariate, bivariate and multivariate logistic regression analyses. The main outcome measure was stillbirth rate in the hospitals (individually and overall).ResultsThere were 4416 single births and 175 stillbirths, and a mean stillbirth rate of 39.6 per 1000 births (range: 12.7 to 67.3/1000 births) in the hospitals. Antepartum (macerated) constituted 22.3% of the stillbirths; 47.4% were intrapartum (fresh stillbirths); while 30.3% was unclassified. Acute hypoxia accounted for 32.6% of the stillbirths. Other causes were maternal hypertensive disease (6.9%), and intrapartum unexplained (5.7%) among others. After adjusting for confounding variables, significant predictors of stillbirth were referral status, parity, past experience of stillbirth, birth weight, gestational age at delivery and mode of delivery.ConclusionWe conclude that the rate of stillbirth is high in Nigeria’s referral hospitals largely because of patients’ related factors and the high rates of pregnancy complications. Efforts to address these factors through improved patients’ education and emergency obstetric care would reduce the rate of stillbirth in the country.Trial registrationTrial Registration Number NCTR91540209.Nigeria Clinical Trials Registry. http://www.nctr.nhrec.net/Registered April 14th 2016.

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Section: Discussionmentioning

confidence: 99%

Prevalence and determinants of stillbirth in Nigerian referral hospitals: a multicentre study

Okonofua

Ntoimo

Ogu

et al. 2019

BMC Pregnancy Childbirth

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“…Mortality among babies in utero on or after 28 weeks (stillbirths) and in the first four weeks of life—a timeframe that includes both perinatal (≥28 weeks in utero to 7 days after birth [3]) and neonatal (≤28 days after birth)—results from a combination of medical causes, social factors, and system failures that vary by context [4,5]. Much of this mortality is attributable to the lack of quality maternal care before and during birth and neonatal care immediately after birth [1,6]. Improved care at birth has the potential to prevent almost half of all stillbirths in the intrapartum period as well as reducing preventable maternal and neonatal deaths [7].…”

Section: Introductionmentioning

confidence: 99%

Systematic identification of facility-based stillbirths and neonatal deaths through the piloted use of an adapted RAPID tool in Liberia and Nepal

et al. 2019

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Maternal, fetal, and neonatal health outcomes are interdependent. Designing public health strategies that link fetal and neonatal outcomes with maternal outcomes is necessary in order to successfully reduce perinatal and neonatal mortality, particularly in low- and middle- income countries. However, to date, there has been no standardized method for documenting, reporting, and reviewing facility-based stillbirths and neonatal deaths that links to maternal health outcomes would enable a more comprehensive understanding of the burden and determinants of poor fetal and neonatal outcomes. We developed and pilot-tested an adapted RAPID tool, Perinatal-Neonatal Rapid Ascertainment Process for Institutional Deaths (PN RAPID), to systematically identify and quantify facility-based stillbirths and neonatal deaths and link them to maternal health factors in two countries: Liberia and Nepal. This study found an absence of stillbirth timing documented in records, a high proportion of neonatal deaths occurring within the first 24 hours, and an absence of documentation of pregnancy-related and maternal factors that might be associated with fetal and neonatal outcomes. The use of an adapted RAPID methodology and tools was limited by these data gaps, highlighting the need for concurrent strengthening of death documentation through training and standardized record templates.

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“…Antenatal care has the major objective of ensuring optimal health outcomes for the mother and her baby (Statistics, 1977). When properly designed and executed, antenatal care helps to monitor the pregnancy and reduce morbidity risks for the mother and the child during pregnancy and delivery (Statistics, 1977;Goldenberg and McClure, 2018). Even though, prevention of stillbirth is not identified as a primary goal of antenatal care, it does help to reduce the incidence of stillbirth, as less frequent visits, especially in the third trimester of pregnancy has been shown to be associated with a higher risk of stillbirths (Olusanya and Solanke, 2009;Goldenberg and McClure, 2018).…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…A double-prong approach of holistic antenatal care and vigilant intra-partum care are desirable for effective prevention of stillbirths (Di Mario, Say and Lincetto, 2007;Ezugwu et al, 2011;Goldenberg and McClure, 2018). Antenatal care, tailored to make provision for more frequent visits after the 36weeks of gestation has been found to be associated with less incidence of stillbirths (Di Mario, Say and Lincetto, 2007;Ezugwu et al, 2011;Vogel et al, 2013;Goldenberg and McClure, 2018). Similarly, confinement in an accredited health facility where skilled maternity care attendants are available is essential for the reduction of stillbirths that occur during the intra-partum period (Tayelgn, Zegeye and Kebede, 2011;Hailemichael, Woldie and Tafese, 2013;Ballard et al, 2016;Kayode et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

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2019

jhms

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Placenta typically discoid in shape and echogenic (hyperechoic) structure visible on ultrasound. Placenta may be extend to the lateral wall of uterus but normally lies along the anterior and posterior wall of the uterus. The thickness of placenta is 2.0cm to 2.5cm and measuring diameter 22cm. In various times placenta abnormally located along the internal cervical os of uterus which may be partially or fully covered the os that's called placenta previa. Prevalence of placenta previa occurs in approximately 5 per 1000 pregnancies. Prevalence of Placenta previa is rising as a result of increasing rates of LSCS (Lower segment cesarean section). Placenta previa leads many adverse outcomes during pregnancy for both fetus and maternal so it is require follow up scan at term. Objective: The main objective is to estimate the sonographic correlation of placenta previa with pregnancy outcomes after 24weeks of gestation. Methodology: A cross sectional analytical study conducted at Tertiary care Teaching Services Hospital Lahore. Maternal diagnosed with placenta previa after 24 weeks of gestation included and also only singleton pregnancies. Maternal observed with follow up scans throughout term and analyzed perinatal outcomes. GE Logiq S8 Ultrasound machine, with 3.5MHz convex probe used for the evaluation of patients. Results: Total 77 patients. We observed among maternal with high grade (type three and four) placenta previa are highly significant and associated with outcome cesarean deliveries. Then those minimum maternal with low grade (type one and two) placenta previa are not highly significant. Another result we find out those maternal who have previous history of Lower segment cesarean section associated with placenta previa.

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Importance of prenatal care in reducing stillbirth

Cited by 11 publications

References 0 publications

Prevalence and determinants of stillbirth in Nigerian referral hospitals: a multicentre study

Prevalence and determinants of stillbirth in Nigerian referral hospitals: a multicentre study

Systematic identification of facility-based stillbirths and neonatal deaths through the piloted use of an adapted RAPID tool in Liberia and Nepal

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