Annual clinical report 1985 : department of obstetrics and gynaecology

Abstract

The monthly statistics (IIa) suggest that there is a peak in deliveries in July-September period. There does not seem to be a definite pattern for stillbirths or early neonatal deaths, but there may have been a rise in April-June period when about 32% of perinatal deaths occurred. The total number of S.L.H. deliveries has dropped by 1.4% in consistence with the drop in the birth rate (lIb). The operative delivery rates have remained approximately the same with a minor drop in both elective and emergency Caesarean Sections. The induction rate has also decreased by 3.2%. The assisted breech delivery rate has also decreeased substantially since 1979 probably reflecting a more frequent Caesarean section rate. The Multiple pregnancy rate is about 1.2% (Ill) and carries a high perinatal mortality rate. The numbers are too small to be statistically manipulated and compilation of data over several years is necessary. A large percentage of these babies are born at a gestational age under 37 weeks (21.2%) while about 41.0% have a birth weight of under 2500 g. Both these groups have a high perinatal mortality rate (see IV h/i). Efforts should be made to decrease this. Preventive action can be undertaken if diagnosis of multiple pregnancy is made early - a routine ultrasound at 18 weeks will identify multiple pregnancy early, besides helping to accurately date all pregnancies. Once identified, patients carrying a multiple pregnancy can be assessed by a vaginal examination every 2 weeks from 24 weeks onwards. Any cervical dilatation or effacement developing is suggestive of possible premature labour, and these patients can be admitted for hospital rest. The neonatal unit needs to be improved since deaths from prematurity, while having improved (IVk), still remain an important cause of perinatal deaths. [excerpt from the summary]