Introduction: Stillbirth is a tragic events for parents and obstetricians. Still birth is defined as “delivery of a foetus that has died before birth for which there is no possibility of resuscitation, after 24 weeks of gestational age (After a period of viability) and/ or birth weight ≥500 grams.” In INDIA period of viability is ≥28 weeks.
Objectives: To study the following factors in relation to occurrence of Stillbirth in Obstetrics and Gynaecology department R.N.T.M.C. Udaipur.
1Incidence of Still birth over the time period of study.
2Etiological factors and risk factors of still birth.
3Study the role of antenatal care in prevention of foetal death.
Materials and Methods: Pregnancies diagnosed with stillbirth will studied retrospectively in department of obstetrics and gynaecology, R.N.T.M.C., Udaipur from 1 July 2017 to 30 June 2018 from hospital records.
Results: In our study 19723 births occurred, out of which total stillbirths were 929 (4.7%). Stillbirth rate in this period in our hospital was 47 stillbirths /1000 total births. Out of 929 stillbirths Ante-partum (Macerated) are 384 (41.33%) and Intra-partum (fresh) are 545 (58.66%). Stillbirth rate was highest (6.7%) in teenage patients and then again rise in ≥30 years of age women (5.6%). Risk of stillbirth was higher in primigravidas (7%) and multigravidas ≥ fourth (10%). In our study largest percentage of stillborn babies were preterm (54.7%) between gestational age of 29-36 weeks, 25.3% stillbirths were ≤28 weeks of gestational age. 92.68% (861) patients had absent foetal heart sound at admission. Nearly half 50.8% (n=472) stillbirths occurred in patients whose foetal birth weight was ≤1500 grams. In our study large percentage of stillbirths i.e.81.7% (n==759) occurred in the Un-booked emergencies. In our study patients having Haemoglobin level <5 gm%, 40% births result in Stillbirths. In patients whose haemoglobin was 5-6.9 gm%, Stillbirth incidence is 13.5%. Largest no. of stillbirths occurred in rural areas 787 (84.71%). In 26.48% (n=246) cases exact cause of Stillbirth remain undetermined. Among determined causes commonest cause was placental pathology 192 (20.67%). 112 (12.05%) stillbirths had congenital malformation. Most common was anencephaly. In our study 9.6% cases had hypertension in pregnancy.
Conclusion: In our study leading cause are placental pathology, congenital malformation, hypertension in pregnancy, foetal distress. majority of cases had no FHS at admission and they did not have proper antenatal check- ups. Significant proportion of Stillbirth is preventable by health education to adolescents girls and parents about regular and proper antenatal check –ups, warning signs during antenatal period, hospital delivery and early referral.