Autopsy studies on still births in Korle Bu Teaching Hospital. II: Causes of death in 93 still births

Abstract

In this second of three reports dealing with autopsy studies in 93 still births at the Korle Bu Teaching Hospital, Accra, the causes of death are described. Causes of death were grouped using a combination of the modified Aberdeen and Naeye's classification. Asphyxia was the commonest cause of death accounting for 56% of deaths. The single largest contributing factor to fetal hypoxia was antepartum haemorrhage. Foetal infections were responsible for 13% of deaths and maternal pathologic conditions for 10.8%. The commonest maternal condition causing stillbirth was severe pre-eclampsia. Death was due to fatal birth trauma in 5.4% of cases with lethal congenital malformations and placental growth retardation causing 3.2% of deaths each. It is concluded that the vast majority of factors causing or contributing to late foetal deaths are largely preventable and or controllable. It is recommended that antenatal attendance should commence early and be regular and maternal and foetal monitoring be improved so that potential life threatening conditions can be diagnosed early, appropriate management and counselling instituted and therapeutic abortion or delivery planned. Routine examination of placentae at birth and genetic studies in suspicious cases will enable obstetricians counsel parents about the possibility of occurrence of stillbirth or congenital abnormality in future pregnancies. Autopsy examination of stillbirths is encouraged as this may help elucidate deaths in the cases now classified as due to unknown or unexplained causes.