A PEER-REVIEWED JOURNAL OF RESEARCH AND CLINICAL MEDICINEISSN 1727-2378 (Print)         ISSN 2713-2994 (Online)
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The Relationship of Rates and Causes of Stillbirth to Obstetric Facility Level

DOI:10.31550/1727-2378-2020-19-8-55-61-65
For citation: Kamilova M.Ya., Dzhonmakhmadova P.A., Ishan-Khodzhaeva F.R. The Relationship of Rates and Causes of Stillbirth to Obstetric Facility Level. Doctor.Ru. 2020; 19(8): 61–65. (in Russian). DOI: 10.31550/1727-2378-2020-19-8-55-61-65

Study Objective: To compare the rates and causes of stillbirth in level 2 and 3 obstetric institutions1.

Study Design: This was a retrospective group study.

Materials and Methods: Statistical data and labor and delivery histories of women who experienced stillbirth and were admitted to obstetric facilities (two level 2 facilities and one level 3 facility) between January and June 2019 were reviewed. Retrospective analysis was done of their labor and delivery histories, and the cases of stillbirth were clinically analyzed, using the ReCoDe classification.

Study Results: The frequency of stillbirth was higher in the level 3 hospital. Irrespective of the level of hospital, mortality in the antenatal period dominated (four out of six cases in the level 2 facilities and 104 out of 129 in the level 3 facility); it was more often due to congenital malformations in the level 2 facilities and to intrauterine growth restriction (IUGR) or placental insufficiency in the level 3 facility. In the level 3 hospital, the most common causes of intranatal fetal death included maternal (pre-eclampsia and extragenital diseases) and fetal (IUGR) disorders that developed before labor.

Conclusion: The actual causes, as established in this study, of negligence leading to stillbirth demonstrate that there is potential for reducing perinatal mortality.

Contributions: Dr. M.Ya. Kamilova supervised the study, developed the concept and design of the study, analyzed the data, and participated in writing the paper. Dr. P.A. Dzhonmakhmadova collected material, did statistical analysis, and participated in writing the paper. Dr. F.R. Ishan-Khodzhaeva did statistical analysis and was scientific editor.

Conflict of interest: The authors declare that they do not have any conflict of interests.

M.Ya. Kamilova (Corresponding author) — Research Institute of Obstetrics, Gynecology, and Perinatology (a State Institution), Ministry of Health and Social Protection of the Republic of Tajikistan; 31 Mirzo Tursunzade St., Dushanbe, Republic of Tajikistan 734002. eLIBRARY.RU SPIN: 2527-2877. https://orcid.org/0000-0002-2525-8273. E-mail: marhabo1958@mail.ru

P.A. Dzhonmakhmadova — Research Institute of Obstetrics, Gynecology, and Perinatology (a State Institution), Ministry of Health and Social Protection of the Republic of Tajikistan; 31 Mirzo Tursunzade St., Dushanbe, Republic of Tajikistan 734002. https://orcid.org/0000-0002-9457-961X. E-mail: parvina2055@gmail.com

F.R. Ishan-Khodzhaeva — Tambov City Clinical Hospital No. 3 (a Tambov Region Government-funded Healthcare Institution); 234/365 Karl Marx St., Tambov, Russian Federation 392000. https://orcid.org/0000-0002-9211-1124. E-mail: kachyona@mail.ru

Доктор.ру

Table 1

Rates of stillbirth in level 2 and 3 hospitals between January and June 2019

t10_1.jpg

Fig. Ratio of antenatal and intranatal fetal deaths by level of hospital

r10_1.jpg

Table 2

Main causes of antenatal fetal death in the hospitals studied

t10_2.jpg

Table 3 Main causes of intranatal fetal death in the hospitals studied

t10_3.jpg 

Received: 10.02.2020

Accepted: 03.03.2020

____________

1 Level 2 obstetric facilities provide obstetric and neonatal care, including management of pathological labor, cesarean section, and neonatal care to babies born at week 35 of gestation or later with body weight at birth 2,000 g or more. Level 3 obstetric facilities provide high-technology obstetric and perinatal services to pregnant women, parturients, and puerperants at high risk and babies born before week 35 of gestation with body weight at birth below 2,000 g.


LITERATURE
  1. De Bernis L., Kinney M.V., Stones W., Hoope-Bender P.T., Vivio D., Leisher S.H. et al.; Lancet Ending Preventable Stillbirths Series Study Group; Lancet Ending Preventable Stillbirths Series Advisory Group. Stillbirths: ending preventable deaths by 2030. Lancet. 2016; 387(10019): 703–16. DOI: 10.1016/S0140-6736(15)00954-X
  2. Blencowe H., Cousens S., Jassir F.B., Say L., Chou D., Mathers C. et al. National, regional, and worldwide estimates of stillbirth rates in 2015, with trends from 2000: a systematic analysis. Lancet. 2016; 4(2): E98–108. DOI: 10.1016/S2214-109X(15)00275-2
  3. Galimova I.R., Khusainova D.K., Evgrafov O.Yu. Comparative analysis of stillbirth cases according to Republic Clinical Hospital Perinatal Center database. Practical medicine. 2016; 4(96): 20–2. (in Russian)
  4. Shchegolev A.I., Tumanova U.N., Frolova O.G. Regional profiles of stillbirth in the Russian Federation. Published in Current important issues of forensic medical examination and expert practice in regional offices of forensic medical examination. Ryazan, 2013: 163–9. (in Russian)
  5. Kerber K.J., Mathai M., Lewis G., Flenady V.,4 Jan J., Segun T. et al. Counting every stillbirth and neonatal death through mortality audit to improve quality of care for every pregnant woman and her baby. BMC Pregnancy Childbirth. 2015. 15(suppl. 2): S2–9. DOI: 10.1186/1471-2393-15-S2-S9
  6. Butkeeva A.A., Sapakhova E.Kh. The problem of intranatal fetal death. International journal of applied and fundamental research. 2014; 2(p. 2): 135–7. (in Russian)
  7. Posiseeva L.V., Peretiatko L.P., Kulida L.V., Khamoshina M.B. Placental factors of mortinatality: possibilities of prevention. Russian Bulletin of Obstetrician-Gynecologist = Rossiyskiy vestnik akushera-ginekologa. 2014; 5: 83–6. (in Russian)
  8. Frolova O.G., Pismenskaya T.V. Reducing antenatal loss: An important goal for the out-patient obstetric and gynecological service. Handbook for nurse practitioners and midwives. 2014, 4: 10–3. (in Russian)
  9. Aminu M., Unkels R., Mdegela M., Utz B., Adaji S., van den Broek N. Causes of and factors associated with stillbirth in low- and middle-income countries: a systematic literature review. BJOG. 2014; 121(suppl. 4): S141–53. DOI: 10.1111/1471-0528.12995
  10. Gardosi J., Kady S.M., McGeown P., Francis A., Tonks A.; Perinatal Institute, Birmingham. Classification of stillbirth by relevant condition at death (ReCoDe): population based cohort study. BMJ. 2005; 331. DOI: 10.1136/bmj.38629.587639.7C

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