engleski

Causes of perinatal death at Osijek Clinical Hospital, 1995-2004

Perinatal mortality and the causes of perinatal death as determined by autopsy and by placental biopsy at the Osijek Clinical Hospital in the period 1995 – 2004 are presented. The data were collected at the Department of Pathology: the autopsy reports and the placental biopsy reports were reviewed. The causes of death were classified into 10 categories: intrauterine hypoxia and birth asphyxia, congenital malformations, infection, abnormal pulmonary function, intracranial hemorrhage, immaturity, other diseases, macerated fetus with no signs of asphyxia, tumors, and violent death. The asphyxia was later subdivided into 3 categories: failure of blood to become oxygenated in the placenta, obstruction to circulation through the cord, and of unknown cause. Descriptive statistics are presented. There were 23.860 deliveries at the Osijek Clinical Hospital in the period 1995 – 2004. In this period, there were 540 children deaths, and the autopsy was performed in 534 cases (98.89%). Perinatal mortality values were: 21.31‰ (1995), 17.47‰ (1996), 12.73‰ (1997), 17.75‰ (1998), 13.23‰ (1999), 11.90‰ (2000), 7.97‰ (2001), 13.81‰ (2002), 13.35‰ (2003), and 10, 38‰ (2004). The majority of deaths were in fetuses and infants who showed evidence of asphyxia (58.33%): 71.43% of those cases was attributed to the failure of blood to become oxygenated in the placenta, 9.21% to the obstruction to circulation through the cord, and the rest 19.36% were of unknown cause. Congenital malformations (11.49%) ranked second, abnormal pulmonary function (9.26%) third, both immaturity and macerated fetus (6.29% each) fourth, and other conditions were far behind. In the group of 66 congenital malformation, the most common were multiple organs malformations (50%), followed by central nervous system malformations (16.67%), and heart and large blood vessel malformations (12.12%). In the early perinatal period, the most common causes of death were intrauterine hypoxia (53.62%), immaturity (14.01%), and macerated fetus with no signs of asphyxia (13.52%). Whether death should be attributed to one cause or another is often subject to variable opinion because of the much overlap among groups. Most of the deaths attributed to asphyxia were explained by placental biopsy report. The placental biopsy report must be an integral part of a autopsy report in the cases of the perinatal death.

perinatal death

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