Reduction of Perinatal Mortality in Rayong Hospital

Abstract

Objective To determine whether perinatal mortality could be improved after the interventions.

Interventions 1. Determination of gestational age by sonogram as necessary. 2. All high risk pregnant women are assessed for fetal well being at ANC clinic and referred to the high risk clinic. 3. Partogram is used routinely in the labour room. 4. Specific protocol for preterm labour including steroid administration and inhibition of labour are attempted in preterm labour less than 34week gestation barring contraindication. 5. Perinatal conference is held monthly

Design Before and after study.

Setting Obstetric unit, Rayong Hospital. Subject All deliveries at obstetric unit Rayong Hospital during Oct1,1997-Sept30,1998. The  study was divided into 2 periods, period I during Oct1,1997-Mar 31,1998 and period II, after interventions, during Apr1,1998-Sept 30,1998.

Result There were 5309 births during the study period, 2767 births in period I and 2542 births in period II. The perinatal mortality rates were 16.98 and 10.23 during period I and II respectively. The most common cause of death were asphyxial condition in both periods. Perinatal mortality seemed to be improved in death related to immaturity group. While no improvement was found in othern categories.

Conclusion Improvement of perinatal mortality can be achieved by the interventions conducted in Rayong Hospital. Despite the fact that these interventions are considered standard obstetric practice, they are rarely practiced in many provincial hospitals. Continuous quality improvement should be adopted in order to deliver better perinatal care.