Perinatal Mortality Report in the months of March

and April 2021 G.C at HFSUH

Presenters: Mohammed.
A (OBGYN
Fiseha. A R2)

1
 OUTLINE
 Objective
 Introduction
 Summary
 Comments
 Recommendations
 References

2
 Objectives:
⚫ GENERAL:-
⚫ To report & discuss the PNM of March and April, so as improve the quality of
Perinatal
care
⚫ SPECIFIC:-
⚫ To determine the Perinatal mortality rate of the two months
⚫ To Compare them with regional, national , previous report
⚫ To see the distribution of Perinatal deaths by maternal demographic and obstetric
characteristics
⚫ To identify possible modifiable causes of the Perinatal deaths

3
 Introduction…
⚫ Epidemiology
⚫>3.3 million stillbirths and over 3 million ENDs are estimated to
take place every year.
⚫98% in the developing countries
⚫About half of this delivered at home unnamed , unrecorded and
thus unaccounted
⚫The perinatal mortality rate is five times higher in developing than
in developed regions

4
 ⚫ Neonatal deaths and stillbirths stem from
⚫Poor maternal health, inadequate care during pregnancy
⚫Inappropriate management of complications during pregnancy and
delivery
⚫Poor hygiene during delivery and the first critical hours after birth, and
⚫Lack of newborn care

5
 ⚫ In Ethiopia, according to the 2004 WHO estimation, there were a total
of 128,000 perinatal deaths, making the PMR to be 41/1000
births.

⚫ Of these, 34,000 (27%) were still births and 94,000 (73%) were
early neonatal deaths (ENNDs).

⚫ In 2006, however, the PMR estimated by WHO was 57/1000 total

births.

6 ⚫ EDHS 2016 PMR were 33/1000

 The Perinatal Mortality
Rate

7
 Perinatal
Audit
⚫The systematic, critical analysis of the quality of perinatal
care including:
⚫The procedures used for diagnosis and treatment
⚫The use of resources
⚫The resultant outcome and
⚫The quality of life for women and their babies

8
 Principles of perinatal audit
⚫It is a sensitive indicator of the quality of service provided to pregnant

women and their newborn

⚫It promotes an opportunity to learn from experiences without

generating feeling of guilt and blame

⚫Aims to optimize clinical performance and provide the best possible

services to patients.

9
 The Goals of Perinatal Mortality
Audit
⚫ To identify perinatal mortality rates
⚫ To determine the causes of perinatal
deaths
⚫ To identify modifiable factors
⚫ To look for solutions

10
 Six-step Cycle for Perinatal Mortality
Audit

11
 Causes of perinatal
mortality
⚫ Developing Countries
⚫ Developed Countries
⚫Mechanical factors
⚫Congenital malformations
⚫Antepartum hemorrhage & chromosomal
⚫Hypertensive disorders abnormality
⚫Prematurity ⚫LBW or prematurity
⚫Lethal congenital ⚫Sudden infant death
anomalies syndrome
⚫Unexplained ⚫Maternal complication
⚫Unintentional in juries
⚫ unexplained
12
 Causes of Perinatal Mortality in Ethiopia as Compiled from
Hospital Based Data

13
 Overview of Delivery Statistics of HFSUH in the Month
of March and April 2021 G.C
⚫ Source of Data
⚫Labor ward delivery registration
form
⚫NICU registration form
⚫Patients’ medical charts
⚫OR registration book

14
 Deliveries in March and April 2021 G.C. in
HFSUH
Total number of deliveries 464 384

Twin delivery 18 5

Triplet 0 0

Total number of babies born 482 389

Delivery rate per day ≈ 14.96 12.8

15
 Comparison of deliveries of four
Teaching Hospitals
1200

988 975
1000

800
625
600
445 464
384 379
400

200

0
BL ZM GM HFSUH- HFSUH-A SPHMM HFSUH
16 H H H M C J
 Place of deliveries in the month of March
and April 2021 G.C HFSUH
PLAC
350 E

300
321
250

254
200

150
PLACE

100
143
118
50

0
0

OBS OR- LABOU OBS OR- LABOUR. ISOLATION

M R. A WARD-A
17 WARD-M
 Distribution of delivery by age group of mothers
who delivered in the month ofMarch and April
2021 G.C HFSUH
Chart Title
AGE-M AGE-
A
212 20
4
169
14
8

47 4
36 2 1
9

18 ≤18 19_24 25_34 ≥35

 TABLE-1 Frequency and Percentage distribution of deliveries by
Mode of Deliveryin the month of March and April 2021.G.C
Mode of delivery Frequency % Frequency %

Spontaneous vaginal Delivery 259 55.8 219 57

C/S 139 29.9 114 29.7

Vacuum Delivery 43 9.27 38 9.9
Forceps Delivery 3 0.65 0 0
Assisted breech 15 3.23 7 1.8
Laparotomy 4 0.86 4 1.04
Destructive 1 0.22 0 0
Total 464 100 384 100
19
 Trends of C/S rates at HFSUH during the past 4
months CS
%
29.5 29.8 29.9 29.7
28.9
22.3 25.7

Jan- De 21-Jan Feb- Mar- Apr-

19 c CS 21 21 21
20 %
 Percentage of C/ S EDHS
2016
EDHS
2016
21.
4

5.
3
2 2. 1.
0. 3 0. 1 1.
0. 9 3
7 9 4

21
 TABLE -2 Frequency and percentage distribution of
deliveries by SEX in March and April 2021
HFSUH
Sex Frequency % Frequency %

Male 269 55.8 204 52.4

Female 213 44.2 185 47.6

Total 482 100 389 100

22
 HIV Serostatus of
mothers Chart
500 Title
461
450

400

381
350

300

250
Serostatus -
200
M
150 Serostatus-A
100

50

2 3 1 0
0
REACTIVE NON- UNKNOWN
REACTIVE

23
 Distribution Of Deliveries By Birth Weight
400
357
350 324
300

250

200 WEIGHT-
M
150 WEIGHT-A
100 82
49
50 25
13 18 11
0
1000-1499 1500-2499 2500-3999 >_4000
24
 Perinatal mortality in the month of March 2021
G.C
 Perinatal mortality rate =

late fetal death + early neonatal death X

1000 live births + late fatal deaths

25
 Perinatal mortality in the month of March 2021
G.C

26
 Cont.…..

27
 In Hospital PNM in
March
⚫ Still birth= 46
 IUFD referred from other = 32
 Lethal congenital anomaly= 6
 HFSUH= 8

⚫ END= 17
 Intra facility CPNMR = (17+ 8- 6) X 1000
(482-32-6)

= 42.8/1000
births
28
 Perinatal mortality in the month of April 2021
G.C

 Perinatal mortality rate =

late fetal death + early neonatal death X
1000 live births + late fatal deaths

29
 Perinatal mortality in the month of April 2021
G.C

30
 Cont.…..

31
 In Hospital PNM in April
⚫ Still birth=41
 IUFD referred from other = 28
 Lethal congenital anomaly= 5
 HFSUH= 5

⚫ END= 9
 Intra facility CPNMR = (9+ 5- 5) X 1000
(389-28-5)

= 25.3/1000 births

32
 Perinatal Mortality
⚫ NATIONAL PNMR=33/1,000births
 Regional PNMR (Harari) =
40/1,000births
⚫ Regional PNMR(Oromia)=30/1000births
⚫ PNMR of HFSUH J = 124.1/1000births
 PNMR of HFSUH F=100 / 1000births
⚫ PNMR of HFSUH M= 119.7
/ 1,000births
⚫ PNMR of HFSUH A= 109.4 /1000births

33
 National Perinatal Mortality Trend EDHS
2016
60
50
50 47
44
40
40 36
30 29 28 28
30 26 26
National
20 figure
EDHS 2016
10 33/1000birth

34
 Place of perinatal death in March and April 2021
G.Cthe perinatal death on
Among Among the perinatal death on April
March
⚫ 28 were Antepartum death
⚫ 32 were Antepartum death
outside hospital
outside hospital
⚫ 5 had lethal congenital
⚫ 6 had lethal congenital anomalies
anomalies
⚫ 5 Were Intrapartal death at
⚫ 8 Were Intrapartal death at hospital
hospital
35
⚫ 9 were END
⚫ 17 were END
 PMR for sex of new born
PN PN
M M

FEMAL
46.1%(29 E
) 37%
53.9%(34
) MAL
MALE E
63%
FEMAL
E

36
 Gross Perinatal Mortality Rate of the last 4
months of deliveries in HFSUH
146.8
130.
7 120.
112.3
97. 8
95. 89. 94.
89. 8
79. 2 6 6
9
65. 8
3

MESKEREM YAKATIT MEGABIT NO DE JA FEB APRI

HIDAR SEP VSeries C N MARCH L
1

37
 Corrected Perinatal Mortality Rate of the
last 4 months of deliveries in HFSUH
124. 119.7
1 109.
10 4
0
79. 81.
74. 77.
8 1
5 1
53. 52. 6
2 9 0

MESKERE TIR YEKATIT 2011 MEGABIT SEP 19- 19-DEC 21- FEB-21 21- 21-
M 2011 2011 2011 19 NOV JAN MAR APR

Series
1

38
 Distribution of PNM by Mode of
40
Delivery
35 34
32
30

25

20 18

15

10

5 4 5
4
5 3 2
1 1
0
0
SV C/S LAPARATOMY Instrument AB DD
D D

NUMBER- NUMBER-
39 M A
Distribution of PNM by Type of
Gestation
Gestation-M Triple Gestation-A Twi Triple
t n t
Twi 0% 3% 0%
n
11%

Singleton
e 89%
Singleton
e 97%

40
 Distribution of mothers with perinatal death by their status of
booking
Booke Not
d booked Booke Not Unknow
d booked n

7.5%
16.4%

50.8%
36.4%
32.8% 58.1%

The national coverage

of antenatal care is
74% (EMDHS 2019)

41
 Distribution of PNM by Birth
25
Weight
23
21
20
20
18

15
15
WEIGHT-
11 M
10 WEIGHT-A
Series 3
5

1 1
0 0
0
1000-1499 1500-2499 2500-3999 >_4000 unrecorde
42
d
 Table: frequency and percentage distribution of PNM
by Maternal Age in the month ofMarch and
April2021Frequency of
Maternal Age Percentage Frequency of Percentage
deaths deaths

6 10
≤18 3 5.9
40 66.7
19-34 33 72.5
13 21.7
35-40 9 17.6

1 1.6
>40 2 3.9
60 100
Total 47 100

43
 Table : Perinatal Mortality Adjusted for Maternal Age
per 1000 Live Births in March and April
Age No of deaths No of birth PNM/1000 No of deaths No of PNM/1000

birth

≤18 6 36 166.7 3 41 73.2

19-34 40 376 106.4 33 301 109.6
35-40 13 43 302.3 9 36 250

>40 1 9 111.1 2 7 285.7

Total 60 464 129.3 47 384 122.4

44
 Perinatal Mortality Adjusted for Maternal Age
per 1000 Live Births in March and April
PNMR-March PNMR-April
45 40

40 40 35
33
35
30
30
25
25
20
20
15
15
13
10
10
9
5 6 5
3 2
0 0 1 0 0
≤1 19-34 35- >4 ≤1 19-34 35- >4
8 40 0 8 40 0
PNM PNM
R R

45
 Perinatal Mortality Adjusted for Specific Maternal
Age per 1000 Live Births
Chart Title
March-PNMR April-PNMR

250%

286
%
302
73% % 122
110% %
167
% 111% 129
106
%
%

≤1 19- 35- >4 tota

8 34 40 0 l
46
 Distribution of PNM by Place of
Referral March
April

12

9 9 9
8
7 7 7 7
6 6
5 5
4
3 3

no referal kombolch fedi hara haramay Jars bisidimo othe

paper a s r a o r
47
 Frequency and percentage distribution of PNM by possible
cause in the month of March and April 2021 G.C at
HUSH
Causes Frequency % Frequency %

Congenital anomaly 6 9.5 5 15.5

Pre/eclampsia 13 20.6 9 15.5
APH 17 27 12 20.7
Mechanical 12 19 9 15.5
Maternal disorders 2 3.2 1 1.7
Miscellaneous 6 9.5 4 7
Unexplained 7 11.1 7 24.1
Total 63 100 47 100
48
 Summary of the two
months
• 482 and 389 babies delivered from 464 and 384 mothers in March
and April respectively
• The CS rate were 29.9% and 29.7% in March and April
respectively
• Serology for RVI coverage is 99.8% and 100%
• CPNMR 119.7/ 1000births and 109.4/ 1000births
• Of all the perinatal loss ~ 55.6% and 59.6% were IUFD at
admission

49
 Summary
⚫ Among hospital deaths 68% and 64.3% were in NICU and 32%
and 35.7%were in labor ward in March and April respectively.
⚫ Most of the patients come with formal referral paper
⚫ 13.3% in March and 8.3% in April of the PNM mothers have no ANC
follow up
⚫ The commonest cause of death were APH, preeclampsia,
Mechanical, unexplained and congenital.

50
 Comments &Recommendations
⚫ Health Center
⚫Referral delay from HC(feedback, regular meeting and update for
HC workers)
⚫Failure of detection of high risk pregnancy
⚫ ANC
⚫ Increase ANC coverage
⚫ Risk detection and timely link for intervention
⚫ Take time to council mother on danger sign of pregnancy

51
 Cont…
⚫ Labor ward and OR
⚫Poor documentation on Patient cards
⚫Intrapartum follow up should be improved
⚫Poor documentation of obstetric complications(including NICU
referral…
⚫Efforts should be made to identify causes of still birth

52
 Cont….
⚫ NICU
⚫Newborn follow up should be improved
⚫No death summary of died neonates
⚫Incomplete documentation on the registration form
⚫No involvement of NICU team in neonatal
resuscitation
⚫ Card Room
⚫Difficulty of retrieving charts

53
 Reference
s Neonatal and perinatal mortality : country, regional and global estimates.
⚫
© World Health Organization 2016
⚫ Yifru Berhan1, Asres Berhan ,PERINATAL MORTALITYTRENDS IN
ETHIOPIA
,September 2014
⚫ The 2016 Ethiopia Demographic and Health Survey (2016 EDHS)
⚫ Labor ward delivery registry
⚫ NICU department delivery registry book
⚫ Perinatal mortality Audits of HFSUH
⚫ Up-to-date 2018
⚫ Making Every Baby Count Audit and review of stillbirths and neonatal

54
deaths WHO 2016
 CASE
SELECTION

55
 Lethal
NO Anomalies
MRN A Para GA
g
Outc Anomaly
ome
FHB Aberdeen Delivery Referral place

1 573825 30 III 6M 1.2kg Exencephaly +VE congenital ABD Private clinic

2 575537 34 IV 9M 3.3kg Severe +VE congenital DD Tullo HC

hydrocephalus

3 577789 26 P0 9M 1.3kg Anencephaly -VE congenital SVD Jarso HC

4 576453 36 PII 316/7WK 2.5kg None -VE congenital CS Private

S immune
hydrops
56 fetalis
 Lethal
Anomalies
NO MRN Ag Par GA
e a
Outc Anomaly
ome
FHB Aberdeen Delivery Referral place

5 574007 20 1.4kg Anencephaly -VE congenital ABD Haramaya

6 576102
35 1.8kg Hydrops fetalis +ve
congenital
SVD

57
 Lethal
Anomalies
MRN
NO Age Para GA Anomaly FHB Aberdeen Delivery Referal

Outco me
Hydrocephalus+R-MMC
1 579891 35 VI 9M 3kg +Paraplegia +VE congenital INS-Delivry Hakim

Kombolch
2 579551 30 II 9M 1.6kg Anencephaly +VE congenital SVD a HC

3 579493 26 PI 9M 1.4kg Anencephaly +VE congenital SVD Jarso HC

4 578250 36 PII 316/7 2.5kg R-MMC+R/O cyanotic CHD -VE congenital CS -----
WKS
58
 Lethal
NO
Anomalies
MRN Ag Par GA
e a
Outc Anomaly
ome
FHB Aberdeen Delivery Referral
place

R-MMC+bilateral Club foot

5 578270 34 IV 9M 2.7kg + +ve congenital SVD

59
 IUFD on
S/N
arrival Referral CAUSE OF
1 MRN AGE GA ROD Weight FHB ANC Admission diagnosis from DEATH
3rd TMP+Uterine rupture + IUFD + Fechatu mechanical
304617 30 9M TAH 3.4kg -Ve YES HC
Severe Anemia +Breech presentation
1
3rd TMP+APH 2ry Abruption + Moderate
anemia + IUFD Chelenk APH
2 574290 43 9M SVD 2.5kg -Ve NO o
Hospital
3rd TMP + Hypovolemic shock 2ry APH
2ry
Abruptio placentae with active Bisidimo APH
bleeding + IUFD+?DIC
3 574332 35 9M CS 3kg -Ve NO Hospital
3rd TMP+LFSOL+APH 2ry severe
Abruption + IUFD + PE with severe
feature
4 574648 35 8M SVD 1.2kg -VE YES Allee HC APH
3rd TMP + APH 2ry
Placental Abruption
with active bleeding
IUFD on
arrival…….. Midaga HC
6 577653 28 9M SVD 3.6kg -ve NO 3rd TMP+SSOL + IUFD+ Face presentation Mechanical

3rd TMP + Eclampsia + IUFD + ? Harar

7 575203 18 8M SVD 1.5Kg -VE YES Aspiration pneumonia general PE/Eclampsia
Hospita
l
3rd TMP+3Previous CS Scar + PE with severe Jugol
8 575141 28 81/2M CS 1.1Kg -VE YES feature + IUFD PE
Hospita
l

9 575424 18 9M SVD 1.5kg -VE YES 3rd TMP+AFSOL+PE with severe feature + Midaga HC PE
IUFD
3rd TMP+IUFD+PE with severe feature + Kombolc
10 574169 25 8M SVD 1.5kg -VE yes PE
Breech presentation ha HC
3rdTMP +IUFD+APH2ry to Abruption with active Haramay
11 577285 22 7M CS 2.1kg -VE YES
a
APH
bleeding
hospital
Jugol
12 577645 30 9M SVD 3kg -VE 3rd TMP+IUFD+PE with severe feature
Hospita
PE
l
Haramaya
Laparatomy 3rdTMP +Uterine rupture + IUFD
13 577442 25 9M 1.2kg -VE YES General Mechanical
+ Ux repair
61
Hospita
l
IUFD on
arrival…….. 3rdTMP+SSOL+1Previous
14 575814 20 9M CS 3.2kg -ve YES CS scar + CPD 2ry to Kombolcha Mecahnical
contracted HC
pelvis + IUFD
3rdTMP+SSOL+Tranverse
15 575884 35 8M SVD 2.5KG -Ve NO Lie + IUFD Felatu HC Mechanical

3rd TMP+APH2ry to placenta

previa with active bleeding
16 575913 20 9M CS 3.2kg -Ve YES +IUFD+ Hypovolemic shock Fechatu HC APH
2ry ABL

3rd TMP+APH2ry to
576041 35 placental Abruption with Harama APH
17 9M CS 2kg -ve NO
active bleeding ya
+IUFD+ Severe Anemia Hospital
2ry ABL

62
 IUFD On
arrival……..
3rd TMP+APH2ry to severe
18 575787 20 7M SVD 1.2kg -ve YES NO APH
placental Abruption +IUFD

3rd TMP + APH2ry to severe Abruption

19 574651 40 9M CS 2.9KG -VE YES with active bleeding +IUFD+ Bisidi APH
severe anemia 2ry to ABL mo
Hospital

20 3rd TMP + LFSOL + Primigravida +

573757 21 9M SVD 2.4kg -VE YES NO Unknown
IUFD

63
 IUFD ON
ARRIVAL……..

21 574901 26 9M TAH 3.4kg -VE NO 3rd TMP + Uterine rupture + IUFD Chelenk Mechanical
o
Hospital

3rd TMP+IUFD+AKI+? Partial Hrar

22 575223 20 7M SVD 1.2kg -VE YE PE/APH
S HELLP General
syndrome Hospital

3rd TMP +LFSOL + IUFD +PE with

23 576614 20 8M ABD 1.3kg -VE YE severe feature + APH 2ry to NO PE/APH
S placental abruption + Breech
presentation

3rd TMP + IUFD +Hypovolemic

shock 2ry to ABL + APH 2ry to Bisidi
24 577477 30 7M CS 1.4kg -VE NO placental abruption with active APH
mo
bleeding Hospital

64
 IUFD ON
ARRIVAL……..
3rd TMP + IUFD + SSOL
25 577609 18 9M CS 2.8kg -VE NO +Obstructed Labor + Boko HC Mechanical
Primigravida
+ Moderate hydrocephalus

26 575476 20 UnknownSVD 1kg -VE NO 3rd TMP + IUFD + Preterm labor NO PROM

27 574257 35 ---- SVD 2.5kg -ve Eclampsia Eclampsia

575877
28 30 --- SVD 2kg -VE ---------- -------

65
 2 --
9 580304 20 ABD 2.1kg (both -ve -- ----- ---
Twin) --
--
3
575735 20 SVD 4kg -VE
0
3
575727 25 SVD 2.2kg -VE
1

66
 IUFD on arrival of
April
S/N Referral CAUSE OF
1 MRN AGE GA ROD Weight FHB ANC Admission diagnosis from DEATH
SELF
590477 25 8M SVD 1.5Kg -Ve Yes MG+3rd TMP+ IUFD + SSOL Unknown
1
MG+3rd TMP+Unknown date+ One prev CS
scar+2- successfll VBAC + IUFD+P-PROM Kombolch Unknown
2 578371 35 9M SVD 3.6kg -Ve Yes a HC
G-MG+3rd TMP + IUFD+SSOL
3 578360 44 9M SVD 4.2kg -Ve No Bokko HC Unknown

MG+3rd TMP+ One prev CS scar+Uterine Rupture

+ IUFD+Severe Anemia 2ry to ABL
4 578523 27 9M LAP 2.9kg -VE No Bisidimo Mechanical
H

GMG+3rd TMP+APH 2ry PP with active bleeding Garamule

5 578358 21 8M CS 2kg -Ve Yes + IUFD+BOH+ Severe Anemia 2ry to ABL ta H APH

6 578335 20 9M SVD 3.4kg -ve Yes PG+3rd TMP + IUFD+SSOL Fedis HC APH
67
IUFD on
arrival…….. MG+3rd TMP+Unknown date+ One prev Jarso HC
7 440414 28 9M SVD 3.5kg -Ve yes Uknown
CS scar+Optted for TOLAC +
IUFD+AFSOL
PG+3rd TMP + APH 2ND ry to AP+ IUFD
Kombolcha
8 590353 18 8M SVD 1.4Kg -VE YES + LFSOL APH
HC

G-MG+3rd TMP+Uterine Rupture + IUFD+ Ahmed iman

9 579040 25 9M LAP 2.6Kg -VE NO AFSOL+ Severe Anemia 2ry to ABL Mechanical
HC

G-MG+3rd TMP + APH 2ND ry to AP with

10 579149 20 7M CS 1.5kg -VE YES AB+ Bisidimo H APH
IUFD + Severe Anemia 2ry to ABL
MG+3rd TMP+PE with severe feature +APH2r
11 22 8M CS 1.6kg -VE YES y
579359
to Abruption with active bleeding+IUFD Private APH
clinic
PG+3rd TMP+IUFD+Known psychiatric
12 579485 29 ? SVD 2.2KG -VE NO
Px+AFSOL
Harawe HC Unknown

MG+3rdTMP +Twin Px(T-A-Vertex)+ CO-

T-A-2.8kg T-A-
13 579573 20 9M SVD YES TWIN Death(T-A-IUFD)+AFSOL Fedis HC Unknown
T-B-2.9kg Neg

68
 IUFD on
arrival……..
14 579673 20 9M SVD 3kg -VE NO
PG+3rd TMPx+SSOL+IUFD+
Riski HC Unknown
Unknown date
G-MG+3rd TMP+APH2ry to
AP
15 590148 38 8M CS 1.2kg -ve YES Midhega HC APH
with active bleeding +IUFD
+LFSOL

16 578929 35 8M SVD 2.2Kg -Ve yes G-MG+3rd TMP+APH 2ry to Kersa HC APH
AP
+IUFD
MG+3rdTMP+One prev CS s
Lap+U 3.2kg -Ve car
17 529830 30 9M YES +IUFD+ Uterine Rupture+BOH
- Jarso HC mechanical
repair +Short-IPI

PG+3rd TMPx +Unknown

18 579720 25 9M SVD 2.9Kg -VE YES date+ Fedis HC APH
Eclampsia+?Aspiration
Pneumonia
69
+IUFD
 IUFD On
arrival…….. G-MG+3rd TMP + APH with AB+
19 579904 30 9M CS 2.8kg -ve NO Jugal H APH
IUFD + Severe Anemia 2ry to ABL

20 579709 17 9M SVD 2.4KG -VE YES PG+3rd TMP + Breech Px+IUFD Grawa HCl Unknown

21 3rd TMP+ APH with AB+ IUFD

572979 30 -- CS 1.5kg -VE YES Babile APH

70
 IUFD On
arrival……..
22 590362 20 -- SVD 1.2kg -VE YES IUFD --- Unknown

3rd TMP + IUFD

23 579578 25 -- SVD 1.1kg -VE -- Fedis Unknown

3rd TMP + IUFD

24 410358 30 -- SVD 2.7kg -VE --- +Eclampsia+SSOL Kombolcha PE
HC

71
 IUFD On
arrival……..
25 590719 20 -- SVD 3kg -VE -- PG+ 3rd TMP + IUFD + LFSOL Hakim HC Unknown

26 590901 26 Uknown SVD 1kg -VE -- 3rd TMP + IUFD + APH+S. Anemia Gursum APH

27 3rd TMPx+ Eclampsia+ PE/Eclamp

578877 28 SVD 3.4kg -ve IUFD+ Breech Px -- sia
590973 3rd TMP + IUFD + APH+ Breech
28 25 ABD 2.5kg -VE -- D/teyara HC APH
Px

72
 DIED At labor
ward Age Par GA
No Card MOD S Wt AP FHB ANC
Sero
Cause and POR Aberdeen
No. i ty e G stat complication
x AR u s

1 3rd TMPx + AFSOL Felan Mechanical

577642 25 0 9M ABD M 3Kg 0 +ve Unkown NR
+Breech presentation a HC

3rd TMP+PE with severe

561337 28 8M Laparat M 1.4Kg 0 +ve YES NR feature + partial HELLP
2 I o my PE
syndrome

576980 35 IV 9M SVD F 2.5kg 4,2,0 NO NR

3rd TMP+ Retained 2nd Unkno Mechanical
3 +VE twin+Breech w n
presentation
3rd TMPx + APH 2ry to
P. previa with active Harama
4 576297 25 IV 8M CS F 2.2kg 0 +VE NO Unk y a APH
vaginal
n Hospital
bleeding + severe
own
fetal bradycardia
73
 DIED At labor
Car
No d
ward
Age Parit GA
M
O
SEX Wt.
AP
G
FHB
A
N
Seros Cause and
t atus complication
POR
Aberdee
n
y
No. D AR C
3rd TMPx + Eclampsia
2.5k
5 57763 16 PO 8M FD F
g O +VE NO NR + Jarso Eclampsia
6 ?Aspiration HC
pneumonia+
unknown date
6 Early 3rd TMPx +
57107 20 P0 8M SVD M 2kg O +VE YES NR Private APH
Preterm
9
PROM + Primigravida

Garam
3rd TMP +SSOL +OL + Mechani
7 57508 20 P0 9M CS F 3kg 2/2/0 +VE YES NR ul eta
Primigravida ca l
6 Hospital

Extremely preterm Px
295/7 1kg +VE +PE with severe+ Jarso PE
8 57687 21 P0 w ks SVD M 0 YES NR
HELLP syndrome+ HC
74 8
AKI
 DIED AT LABOR WARD
No Car Age Par GA MOD Sex Wt AP FH ANC Sero Cause and complication POR Aberdee
d i ty G B statu n
No. AR s

1 G-MG+3rd TMPx +PE with Hora PE

57875135 IX 7M SVD M 1Kg 0 +ve Yes NR
SF+Pul. Edema+ unknown mitte HC
date

590384 20 8M SVD M 1.2Kg 0 +ve YES NR PG+3rd TMPx+Eclampsia PE/

2 P0
+A.pneumonia+unknown Kersa eclam
date psia

579570 21 p0 7M SVD M 1.1kg 0 Yes NR PG+3 rd TMPx +PE with

Bokko HC Mechani
3 +VE SF+unknown ca l
date
PG+3rd TMPx +
Unkno Haramaya PE/Eclam
4 57852919 P 8M CS F 1050g 0 +VE NO Eclampsia+A.
pneumonia+unknown date
wn Hospital
psia
MG+3rdTMP+PE with
9M CS 2.4kg NR severe feature +1previuos
75 CS scar
+unknown date
 END at
S. MRN NICU
GA Weight Rout diagnosis Hospit ANC Sex Address Aberde
N e of al stay en
deliv
ery
1 577635 28-30 1.2kg SVD Early preterm+ 1and1/ yes F Sofi
VLBW+AGA+Hypothermi 2 days
a + Neonatal jaundice+
apnea(prematurity)

2 577105 Term 3.2kg SVD Term+AGA+NBW+ EONS + 7days yes F Hakim PROM
meningitis +pathologic
jaundice 2ry sepsis+ Baby
of PROM Mother
3 574653 36-38 3.5kg SVD Term+ AGA+ 8hrs No M Sofi
NBW+EONS+?Meningitis+R
uptured MMC + PNA stage
II HIE+Hydrocephalus

76
 END....
S. MRN GA WEIGH Rout diagnosis Hospi AN Sex Address Aberdeen
N . T e of
deliv
tal C
sta
ery y

4 575507 34-36 2.1kg CS Late preterm + AGA + LBW+PNA 2hrs No M Fedis APH
stage III HIE+?EONS+ Baby of
APH mother

5 576019 34-36 1.8kg SVD Late preterm 26hrs Yes M Babile Eclampsia
+LBW+AGA+RDS+
? EONS+baby of
maternal Eclampsia

77
 END....
S.N
. MRN GA WEIGHT Route of
delivery
diagnosis Hospit ANC
al stay
Sex Address Aberde
en
6 576782 30-32 1.2kg SVD early pretem +AGA 1day NO M Haramaya APH
+EVLBW+? EONS+
RDS
7 575614( 32-34 1.7kg SVD Moderate preterm + ? NO M Bedano
TA) AGA + LBW+? EONS
+ TwinA

8 575615( 32-34 1.9kg SVD Moderate preterm + ? NO M Bedano

TB) AGA + LBW+? EONS
+ TwinB

9 577613 38-40 3.1kg SVD Grossly term+ + 17hrs No F Fedis Mechanic

NBW+AGA+PNA stage al
II HIE

10 577551 30-32 1.2kg SVD Early preterm 6hrs yes M kombolcha PE

+VLBW+ AGA +
RDS + Hypothermia

78
 END.....
S.N MRN GA WEIGHT Route of Diagnosis Hospita AN Se Address Aberdan
delivery l stay C x

11 574738 2.5kg CS NBW+AGA + PNA 1day YES F Sofi mechanic

Stage al
III+ ? EONS
+hypothermia
12 577468 Term 3.5kg CS Term+ AGA +NBW + 24hrs NO F Midega APH
Hypothermia + ? EONS
13 574437 ---- 2.7kg SVD Term + NBW + AGA +? 1day ---- M -------- -------
EONS

14 575916{ 32-34 1.6kg SVD Moderate preterm 7days YES F Hakim

( TA) +LBW+AGA+RDS+?
EO NS

79
 END.....
S.N MRN GA WEIGHT Rout Diagnosis Hospital ANC Sex Address Aberdan
e of stay
deliv
ery

15 575915(TB) 32-34 1.4kg SVD Moderate 14days YES F Hakim

preterm +VLBW
+ AGA RDS +
Neonatal
jaundice 2ry
to?+?EONS
16 575606 30-32 1.5kg CS Early preterm 2hrs NO M Falana APH
+ LBW+
AGA+
RDS+? EONS
17 574810 2.5kg CS NBW+ 1day - F
AGA+PNA
stage III+MAS
80
 END at
S.NICU
MRN GA Weigh Route diagnosis Hospit ANC Sex Addres Aberdeen
N week t of al stay s
delive
ry
1 577845 32-34 1.6kg SVD Moderate preterm+ LBW+AGA+ 6days No F Harom
?EONS+Hypothermia+ Hypoglycemia aya
+DIC

2 578896 36-38 2.8kg CS Term+AGA+NBW+ Stage III PNA + 1day No M Fedis

?EONS+Hypothermia+ Hypoglycemia

3 578993 39+2 1.7kg CS Term+ SGA+ LBW+Hypothermia+ 5days Yes M Harom

wk Hypoglycemia +? aya
EONS+R/o meningitis

81
 END....
S. MRN GA WEIGH Rout diagnosis Hospital ANC Sex Addres
N . T e of stay s
deliv
ery
4 590245 34-36 1.5kg CS late preterm+ SGA+LBW+IUGR 3days Yes F Kombo PE
+Baby of PE and known lcha
CHF mother
5 579371 38-40 3.6kg INS- Term + AGA + NBW+? 6days No F Kombo Mechanical
Deli MAS+PNA lcha
v stage II HIE+Subgalial hematoma
ery
6 578870 34-36 1050gm SVD Moderate preterm +VLBW+ 24hrs Yes M Harom RDS
SGA+Twin B+RDS+?EONS+ aya
Hypothermia+ Hypoglycemia
7 578515 2.4kg SVD ------------------------ 4days -- M Erer

8 578770 3.2kg SVD ----------------------- 1day M

9 578529 1kg SVD 1day M

8
2
 THANKYOU!
!

83