Authors : Terhemen Kasso, Justina Omoikhefe Alegbeleye and Israel Jeremiah
Abstract: The death of the fetus in-utero can leave both the mother and the attending clinician devastated. Most intrapartum deaths in developing countries are due to causes that are largely preventable. The situation is worse in the unbooked patient who had no access to skilled attendance. To determine the prevalence and risk factors of intrauterine fetal death among unbooked parturient at the University of Port Harcourt Teaching Hospital. A retrospective study of 344 unbooked women with intrauterine fetal death who presented at the labour ward of the University of Port Harcourt Teaching Hospital between January 1, 2011 and December 31, 2015. Data was obtained from their case/theater records and ward registers, encoded into a spreadsheet and analyzed using SPSS 22.0. Results were presented as means, rates and proportions. Associations between variables were assessed using students t-test and Pearson’s correlation. Differences were considered statistically significant at p <0.05. There were 12,421 deliveries. Of these, 10,136 (81.6%) received antenatal care while 2,285 (18.4%) did not. There was a total of 1,313 perinatal deaths, giving a perinatal mortality rate of 60.9/1000 births in unbooked patients and 18.4/1000 births in booked patients (p <0.01). Majority 149 (43.3%) of the IUFD occurred below 37 weeks gestation and 123 (35.8%) at term. Intrauterine fetal death occurred prior to presentation in 320 (93%) of the patients. This was statistically significant at p <0.01. Most of the women were referred from traditional birth attendants and religious institutions. Hypertensive disorders, abruption placentae, obstructed labour, prolonged pregnancy and Prolonged Rupture of Membranes (PROM) with chorioamnionitis were the most common complications associated with intrauterine fetal death. The leading cause of IUFD were hypertensive disorders, abruption placentae and obstructed labour. Women should be encouraged to register for antenatalcare and deliver in health facilities with skilled attendants.
Terhemen Kasso, Justina Omoikhefe Alegbeleye and Israel Jeremiah, 2020. Determinants of Intrauterine Fetal Death among Unbooked Paturients at the University of Port Harcourt Teaching Hospital, Southern Nigeria. International Journal of Tropical Medicine, 15: 6-10.