Stillbirths among Pregnant Women Admitted to Department of Obstetrics in a Tertiary Care Centre: A Descriptive Cross-sectional Study

Khadka, Dambar; Dhakal, Keshar Bahadur; Dhakal, Astha; Dhakal, Sulochana

doi:10.31729/jnma.7758

Cited by 3 publications

References 15 publications

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Stillbirth rate and associated factors at the Bamenda Regional hospital, North-West region, Cameroon, from 2018 to 2022: a case control study

Mforteh,

Pisoh,

Boten

et al. 2024

BMC Pregnancy Childbirth

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Background Stillbirth is a common adverse pregnancy outcome worldwide, with an estimated 2.6 million stillbirths yearly. In Cameroon, the reported rate in 2015 was 19.6 per 1000 live births. Several risk factors have been described, but region-specific risk factors are not known in the northwest region of Cameroon. This study aims to determine the stillbirth rate and associated factors at the Bamenda Regional hospital, North-West region of Cameroon. Materials and methods A Hospital-based case‒control study conducted from December 2022 to June 2023 on medical files from 2018 to 2022 at the Bamenda Regional Hospital. Cases were women with stillbirths that occurred at a gestational age of ≥ 28 weeks, while controls were women with livebirths matched in a 1:2 (1 case for 2 controls) ratio using maternal age. Sociodemographic, obstetric, medical, and neonatal factors were used as exposure variables. Multivariable logistic regression was used to determine adjusted odds ratios of exposure variables with 95% confidence intervals and a p value of < 0.05. Results A total of 12,980 births including 116 stillbirths giving a stillbirth rate of 8.9 per 1000 live births. A hundred cases and 200 controls were included. Factors associated with stillbirths after multivariable analysis include nulliparity (aOR = 3.89; 95% CI: 1.19–12.71; p = 0.025), not attending antenatal care (aOR = 104; 95% CI: 3.17–3472; p = 0.009), history of stillbirth (aOR = 44; 95% CI: 7-270; p < 0.0001), placenta abruption (aOR = 14; 95% CI: 2.4–84; p = 0.003), hypertensive disorder in pregnancy (aOR = 18; 95% CI: 3.4–98; p = 0.001), malaria (aOR = 8; 95% CI: 1.51-42; p = 0.015), alcohol consumption (aOR = 9; 95% CI: 1.72-50; p = 0.01), birth weight less than 2500 g (aOR = 16; 95% CI: 3.0–89; p = 0.001), and congenital malformations (aOR = 12.6; 95% CI: 1.06–149.7;p = 0.045). Conclusion The stillbirth rate in BRH is 8.9 per 1000 live births. Associated factors for stillbirth include nulliparity, not attending antenatal care, history of stillbirth, placental abruption, hypertensive disorder in pregnancy, malaria, alcohol consumption, birth weight less than 2500 g, and congenital malformations. Close antenatal care follow-up of women with such associated factors is recommended.

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Stillbirth rate and associated factors at the Bamenda Regional hospital, North-West region, Cameroon, from 2018 to 2022: a case control study

Mforteh,

Pisoh,

Boten

et al. 2024

BMC Pregnancy Childbirth

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Prevalence and Determinants of Still birth in Mothers Delivered by Cesarean Section in Orotta National Referral Maternity Hospital: A Cross Sectional Study

Gebremariam,

Tesfai,

Frezgi

et al. 2024

Preprint

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Background: Stillbirth is a growing public health issues worldwide and accounts for majority of perinatal death. In resources limited countries, 40% of stillbirth occurs during labor and this loss could be avoided with improved monitoring and timely access to emergency obstetric care when required. The aim of this study was to determine the prevalence of stillbirth and identify its determinants among mothers delivered by cesarean section. Methods: It was a hospital based retrospective unmatched case control study. Mothers who delivered by cesarean section with the outcome of still birth were cases and three consecutive cesarean section deliveries with live birth were controls. Data were collected using structured data extraction tool developed from literature related to stillbirth and modified according to the local context by the investigators. Variables with p<0.05 in the univariable logistic regression were entered to multivariable logistic regression and declared significant at p<0.05. Results: A total of 380 sampled chart of mother’s delivered by cesarean section were included in study. Of those, 95 were stillbirth and 285 were live birth. The prevalence of still birth on cesarean section deliveries was 3.3% and 48% of stillbirth and 54% of live birth were in mother’s aged 25 to 34 years. Emergency cesarean section was performed in 93% of stillbirth and 71% of live birth. The major indications for cesarean section were antepartum hemorrhage (37%) for stillbirth and mal-presentation (21%) for live birth. Besides, 70% of stillbirth and 73% of live birth have birth weight of 2500-4000gram. The result showed that emergency cesarean section (AOR: 0.32; 95%CI: 0.14-0.75) and male newborn (AOR: 3.03; 95%CI: 1.78-5.19) were found to have a significant association with stillbirth. Conclusion: Our study indicates emergency cesarean section for antepartum hemorrhage was associated with increased stillbirth rate. Focusing on causes of antepartum hemorrhage during antenatal care, appropriate intrapartum monitoring and early risk assessment for complications is paramount for early intervention and prevention of still birth.

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Low Fetal Resistance to Hypoxia as a Cause of Stillbirth and Neonatal Encephalopathy

Shabanov,

Samorodov,

Urakova

et al. 2024

Clin. Exp. Obstet. Gynecol.

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Objective: Low fetal resistance to hypoxia is a factor in stillbirth and neonatal encephalopathy. This review examines fetal movement patterns in response to hypoxia as a predictor of the likelihood of stillbirth. Monitoring the dynamics of fetal movements during maternal apnea could allow the assessment of fetal resistance to hypoxia. The goal of this study is to describe the practical application of this method by doctors and pregnant women. Mechanism: We searched relevant keywords in the international scientific literature databases Scopus and Web of Science, as well as databases for patents granted in China, India, USA, Japan, Germany, Russia and other countries. Devices, drugs and medical technologies that provide diagnosis, modeling, prevention and treatment of intrauterine fetal hypoxia, stillbirth and neonatal encephalopathy were considered. Findings in Brief: During apnea by a pregnant woman in the second half of normal pregnancy, if the maximum duration of fetal immobility exceeds 30 seconds from the onset of breath-holding, then the fetus is considered to show good resistance to hypoxia, thus preserving its health and life during vaginal delivery. On the other hand, excessive fetal movements <10 seconds after the onset of apnea in a pregnant woman indicates low fetal resistance to hypoxia. When fetal resistance to hypoxia is low, there is no alternative to immediate cesarean section for the preservation of fetal life and health. Conclusions: The monitoring of fetal movements during apnea in pregnant women allows real-time assessment of fetal resistance to intrauterine hypoxia. Obtaining timely information on fetal resistance to hypoxia is critical for determining the optimal timing and type of delivery in order to prevent encephalopathy and stillbirth.

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Stillbirths among Pregnant Women Admitted to Department of Obstetrics in a Tertiary Care Centre: A Descriptive Cross-sectional Study

Cited by 3 publications

References 15 publications

Stillbirth rate and associated factors at the Bamenda Regional hospital, North-West region, Cameroon, from 2018 to 2022: a case control study

Stillbirth rate and associated factors at the Bamenda Regional hospital, North-West region, Cameroon, from 2018 to 2022: a case control study

Prevalence and Determinants of Still birth in Mothers Delivered by Cesarean Section in Orotta National Referral Maternity Hospital: A Cross Sectional Study

Low Fetal Resistance to Hypoxia as a Cause of Stillbirth and Neonatal Encephalopathy

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