Perinatal mortality: definition, causes, calculations

The mortality of children before birth and in the first seven days after it - the problem is far from new. If before it could not be solved because of the poor quality of obstetric and gynecological care (after all, maternity hospitals appeared only in the 20s of the XX century, and before that all gave birth to midwives), now perinatal mortality, namely such a term Determines this phenomenon, is closely studied by doctors, statisticians, experts of various organizations.

The very concept of perinatal mortality is the death of the fetus from the twenty-eighth week of intrauterine development to seven days after the birth of the baby. At the moment, all countries have adjusted the indicators so that it is possible to compare statistics and draw conclusions. The study of the causes of perinatal mortality is one of the main tasks of physicians. Knowing the reasons, there will be an opportunity to eradicate this phenomenon.

In order to better understand what is at stake, we will plunge a bit into dry figures. To calculate the perinatal mortality rate, a fetus or a newborn weighing more than one kilogram is taken into account, and if the mass can not be determined, then metric indices are taken into account - the body length should be more than thirty-five centimeters, which corresponds to the twenty-eight weeks of intrauterine development.

The overall statistics consider a fetus weighing more than half a kilogram, a length of twenty-five centimeters, with pregnancy 22 weeks. Why are such figures taken? Since 1993, according to WHO recommendations, it is necessary to provide resuscitation measures from this period of development to children at birth. That is, they are in fact recognized as liveborn, which means that any death of a fetus is considered a death. This is due to the fact that the world knows cases of nursing a child with exactly this weight and at such a time.

If the death occurred after the birth in the first seven days, or the child was born dead, but full and viable, then the doctors taking the delivery are required to notify the civil registration authorities about this. When registering perinatal mortality, a medical certificate of a certain type is issued. If during pregnancy was born not one fruit, then such a certificate is drawn up for each deceased child. To prevent further perinatal mortality, its causes are established by autopsy, which is done necessarily. The final conclusion is issued by the pathologist and how the spine is attached to the certificate.

Among the causes of perinatal mortality is the home birth, which has become fashionable lately. And the mothers often do not think about the fact that home births, in fact, pass without the support of medical personnel, because even present doctors without the necessary medical reanimation equipment can not help the child, if there is such a need. Sometimes home births carry a criminal shade when the mother wants to get rid of the child, causing him special harm. In this case an autopsy is performed by a forensic expert. In fact, this is an excuse for the trial, for here the fault lies entirely with the mother, who, through her actions, did not contribute to the normal course of labor.

If the child dies within the first week, then in the registry office he is registered twice: for the first time as a born, and the second time as a deceased.

When autopsied, physicians often note fetal pathologies, the causes of which are maternal diseases, complications in pregnancy, childbirth.

Perinatal mortality is shown as the ratio of the number of all deaths in perinatal age to the number of all births, multiplied by a thousand. It is very important to conduct a ranking for causes of mortality: from asphyxia, from intrauterine malformations, from pneumonia, from blood diseases. In order to reduce perinatal mortality, pregnant women are monitored, under special supervision are women at risk (primarily infertile, after multiple abortions, with somatic diseases, old-age). In this case, not only physicians, but also the woman herself should be ready for the birth of a healthy child, comply with the doctor's requirements, lead a correct lifestyle, and give up harmful habits.