Division Woman and Baby, University Medical Centre Utrecht, Utrecht, The Netherlands.
Department of Obstetrics and Gynaecology, Mnazi Mmoja Hospital, Zanzibar, Tanzania.
PLoS One. 2021 Jan 14;16(1):e0245196. doi: 10.1371/journal.pone.0245196. eCollection 2021.
To assess the feasibility of the application of International Classification of Diseases-10-to perinatal mortality (ICD-PM) in a busy low-income referral hospital and determine the timing and causes of perinatal deaths, and associated maternal conditions.
Prospective application of ICD-PM.
Referral hospital of Mnazi Mmoja Hospital, Zanzibar, United Republic of Tanzania.
Stillbirths and neonatal deaths with a birth weight above 1000 grams born between October 16th 2017 to May 31st 2018.
Clinical information and an adapted WHO ICD-PM interactive excel-based system were used to capture and classify the deaths according to timing, causes and associated maternal complications. Descriptive analysis was performed.
Timing and causes of perinatal mortality and their associated maternal conditions.
There were 661 perinatal deaths of which 248 (37.5%) were neonatal deaths and 413 (62.5%) stillbirths. Of the stillbirths, 128 (31%) occurred antepartum, 129 (31%) intrapartum and for 156 (38%) the timing was unknown. Half (n = 64/128) of the antepartum stillbirths were unexplained. Two-thirds (67%, n = 87/129) of intrapartum stillbirths followed acute intrapartum events, and 30% (39/129) were unexplained. Of the neonatal deaths, 40% died after complications of intrapartum events.
Problems of documentation, lack of perinatal death audits, capacity for investigations, and guidelines for the unambiguous objective assignment of timing and primary causes of death are major threats for accurate determination of timing and specific primary causes of perinatal deaths.
评估在一家繁忙的低收入转诊医院应用国际疾病分类第 10 版（ICD-10）进行围产儿死亡（ICD-PM）的可行性，并确定围产儿死亡的时间和原因，以及相关的产妇情况。
前瞻性应用 ICD-PM。
坦桑尼亚联合共和国桑给巴尔的姆纳西莫加医院转诊医院。
2017 年 10 月 16 日至 2018 年 5 月 31 日之间出生体重超过 1000 克的死产和新生儿死亡。
使用临床信息和经过改编的世卫组织 ICD-PM 交互式 Excel 系统来捕捉和分类根据时间、原因和相关产妇并发症的死亡。进行描述性分析。
围产儿死亡的时间和原因及其相关的产妇情况。
共有 661 例围产儿死亡，其中 248 例（37.5%）为新生儿死亡，413 例（62.5%）为死产。在死产中，128 例（31%）发生在产前，129 例（31%）发生在产时，156 例（38%）时间不明。一半（n=128/64）的产前死产原因不明。三分之二（67%，n=129/87）的产时死产是由产时急性事件引起的，30%（39/129）原因不明。在新生儿死亡中，40%的死亡是由于产时并发症引起的。
文档记录问题、缺乏围产儿死亡审核、调查能力以及明确分配时间和主要死亡原因的指南，是准确确定围产儿死亡时间和具体主要原因的主要威胁。
