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Max Brinsmead MB BS PhD May 2015

Max Brinsmead MB BS PhD May 2015. Definition The sum of stillbirths and neonatal deaths (in the first week of life for infants weighing >500g (WHO) 400g

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Page 1: Max Brinsmead MB BS PhD May 2015. Definition The sum of stillbirths and neonatal deaths (in the first week of life for infants weighing >500g (WHO) 400g

Max Brinsmead MB BS PhDMay 2015

Page 2: Max Brinsmead MB BS PhD May 2015. Definition The sum of stillbirths and neonatal deaths (in the first week of life for infants weighing >500g (WHO) 400g

DefinitionThe sum of stillbirths and neonatal deaths

(in the first week of life for infants weighing >500g (WHO)

400g (developed world)1000g (suggested) or 22 weeks gestation (often not known)

Per 1,000 total births

Page 3: Max Brinsmead MB BS PhD May 2015. Definition The sum of stillbirths and neonatal deaths (in the first week of life for infants weighing >500g (WHO) 400g

Perinatal Mortality around the WorldRanges from

150 in parts of Africa to...<10 in developed world

A rate of >80 is regarded as “unacceptable”Apparently 40+ in PNGWas 27.9 at PMGH in 2010Is as low as 25 in some developing countries

e.g. Chile, Cuba & Costa Rica

Page 4: Max Brinsmead MB BS PhD May 2015. Definition The sum of stillbirths and neonatal deaths (in the first week of life for infants weighing >500g (WHO) 400g

Worldwide Causes of Perinatal Mortality IUGR stillbirthSyphilis (and a few other fetal infections)Birth asphyxia

Often due to obstructed labour Malpresentation Cord prolapse

Birth traumaSpontaneous pre term birthMaternal causes

Hypertensive disease & eclampsia APH

Prolonged pregnancyCongenital malformations

Page 5: Max Brinsmead MB BS PhD May 2015. Definition The sum of stillbirths and neonatal deaths (in the first week of life for infants weighing >500g (WHO) 400g

Perinatal Deaths NSW 2001-03

Page 6: Max Brinsmead MB BS PhD May 2015. Definition The sum of stillbirths and neonatal deaths (in the first week of life for infants weighing >500g (WHO) 400g

Congenital Malformations that Cause Perinatal Death

Page 7: Max Brinsmead MB BS PhD May 2015. Definition The sum of stillbirths and neonatal deaths (in the first week of life for infants weighing >500g (WHO) 400g

Prematurity as a Cause of Perinatal Death

Page 8: Max Brinsmead MB BS PhD May 2015. Definition The sum of stillbirths and neonatal deaths (in the first week of life for infants weighing >500g (WHO) 400g

Infections that Cause Perinatal Death

Page 9: Max Brinsmead MB BS PhD May 2015. Definition The sum of stillbirths and neonatal deaths (in the first week of life for infants weighing >500g (WHO) 400g

Hypertensive Causes of Perinatal Death

Page 10: Max Brinsmead MB BS PhD May 2015. Definition The sum of stillbirths and neonatal deaths (in the first week of life for infants weighing >500g (WHO) 400g

Obstetric Haemorrhage that Causes Perinatal Death

Page 11: Max Brinsmead MB BS PhD May 2015. Definition The sum of stillbirths and neonatal deaths (in the first week of life for infants weighing >500g (WHO) 400g

Maternal Diseases that Cause Perinatal Death

Page 12: Max Brinsmead MB BS PhD May 2015. Definition The sum of stillbirths and neonatal deaths (in the first week of life for infants weighing >500g (WHO) 400g

Hypoxic Causes of Perinatal Death

Page 13: Max Brinsmead MB BS PhD May 2015. Definition The sum of stillbirths and neonatal deaths (in the first week of life for infants weighing >500g (WHO) 400g

Other Causes of Perinatal Death

Page 14: Max Brinsmead MB BS PhD May 2015. Definition The sum of stillbirths and neonatal deaths (in the first week of life for infants weighing >500g (WHO) 400g

Causes of Neonatal Death

Page 15: Max Brinsmead MB BS PhD May 2015. Definition The sum of stillbirths and neonatal deaths (in the first week of life for infants weighing >500g (WHO) 400g

Perinatal Mortality & Morbidity at John Hunter Hospital

Page 16: Max Brinsmead MB BS PhD May 2015. Definition The sum of stillbirths and neonatal deaths (in the first week of life for infants weighing >500g (WHO) 400g

John Hunter Hospital Audit1998 Perinatal Mortality and Morbidity

Avoidable Factors

None Mother Carers System

56.4%

16.4% 24.5%

2.7%