Perinatal mortality rate-hospital based study

İn 1998 the Perinatal Mortalily Study Group was established at Hacettepe University to determine the causes of perinatal mortality and to calculate perinatal mortality rates at this institution.The study group was constituted by the Department of Pediatrics, Units of Pediatric Pathology, Pediatric Cardiology, Pediatric Surgery, Genetics and Neonatology and the Department of Obstetrics and Gynecology, Perinatology Unit.At the end of every month, each case was discussed among the group including the autopsy results if available, and the cause of mortality was determined according to the Extended Wigglesworth Classification, by the consensus of the group members. Perinatal mortality rates at Hacettepe University were prospectively calculated. Perinatal mortality figures of two periods were compared .(1998-1999 and 2000-2001)

Total number of births over 500 grams was 3173 in the year period 1998 -1999 and 3013 in the year period 2000 - 2001. Perinatal mortality rate was 34,35/1000 in the period from 1/1/1998 to 31/12/1999 and 16,92 /1000 in the period from 1/1/2000 to 31/12/2001. Among perinatal deaths, 61,46 % were intrauterine deaths and 38,54 % were early neonatal deaths in the period 1998-1999. in the period 2000- 2001, 58,83 % were inrauterine deaths and 40 % were early neonatal deaths. İn the period 1998-1999, 62,7 % of the deaths were < 1500 grams, and 46,7 % were between 500-1000 grams. The most common cause of death during this period was prematurity (Extended Wigglesworth Group III) (29,3%), followed by lethal congenital malformations (Group II) (26,6%) and macerated intrauterine deaths (Group I) (22,9%) Autopsy was available in 70,7% of the cases and micronecropsy was available in 12 %. Genetic studies were performed in 24 % of the cases and termination of pregnancy was carried out for fetal anomalies in 10,7 % of the cases.

İn the period 2000-2001 72,54 % of the cases were < 1500 grams and 47,1 % of the cases were between 500- 1000 grams.The most common cause of death during this period was lethal congenital malformations (Group II) (31,4%), followed by macerated intrauterine deaths (Group 1) (21,5%) and specific causes (Group V) (21,5%)). Autopsy was available in 70,17 % of the cases and micronecropsy was obta-ined in 10,52 % of the cases. Twenty percent of the cases underwent genetic studies during pregnancy and termination of pregnancy was carried oııt in 19,29% of the cases.
Perinatal mortality rate has decreased at Hacettepe University during the last 2 years. Most common cause of mortality has changed from prematuriy to lethal congenital malformations in this period. Since oıır institution is a referral center, around 60% of the mortality is due to intrauterine deaths and around 30% of the deaths are due to lethal congenital malformations.