A review of socio-demographic and clinical correlates of stillbirth at a teaching hospital with limited advanced fetal surveillance

Abstract

Background: Stillbirth has a heavy burden of psychosocial and economic cost on women, families and nations. The study aimed at determining the rate of stillbirth and identifying the factors contributing to stillbirths in Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti over the study period. Materials and Methods: The study was a retrospective descriptive one carried out at the Obstetric Unit of Obstetrics, Gynaecology and Perinatology Department of Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti from 1st of January, 2012 to 31st of December, 2016. The data obtained were processed using Statistical Package for Social Sciences (SPSS) computer software version 20. Descriptive statistics was utilized to analyze the data; continuous variables were summarized with mean and discrete variables were summarized using numbers and percentages. Results: There were 532 stillbirths out of a total of 9,364 deliveries during the study period. This gave a stillbirth rate of 56.8/1000 total births. Macerated stillbirths accounted for 232 (43.6%) while fresh stillbirths accounted for 300 (56.4%) of the cases; with majority of the bereaved mothers (86.8%) being unbooked. Stillbirth rate was highest among women aged 15 to 19 years followed by those aged 40 years and above. Infections (chorioamnionitis), 69 (13.0%), obstructed labour. 59 (11.1.%) and antepartum haemorrhage 38 (7.1%) were the leading maternal causes of stillbirth. Prematurity 81 (15.2%) and multiple gestation 38 (7.1%) were the leading fetal causes. In 43 cases (8.1%), there were unexplained causes of stillbirth. Conclusion: as stillbirth remains a largely preventable condition, more aggressive measures should be instituted to ensure comprehensive maternity care for pregnant women; with more emphasis on advanced fetal surveillance arm of antenatal/intrapartum care. Appropriate evidence based post-delivery management, especially in the areas of conduct of baby autopsy and handling of bereavement, should be given to the mothers of the deceased.