An Investigation of the Stillbirths at a Tertiary Hospital in Limpopo Province of South Africa

OBJECTIVE To determine the stillbirth rate and identify the causal factors associated with it in a tertiary hospital. METHODS A retrospective review of records of women who had stillbirths at a tertiary hospital of the Limpopo Province was conducted. The study period was two years from January 1, 2009 to December 31, 2010. The hospital maternity registers were used to identify the women who gave birth during the study period. Data were collected using a data collection form designed for the study. The data collected included maternal age, parity, gestation, mode of delivery, obstetric complications, infant or foetal's gender and weight; whether the birth was fresh stillbirth or macerated and cause of stillbirth. RESULTS There were 5597 deliveries during the two years period of the study. The hospital-based stillbirth rate was 38.4 per 1000 births, with 71% being macerated. The majority of women with stillborn infant in this study were in the age group (24%) 20-34 years, followed by (23%) aged 35 years and older. Nulliparity was associated with stillbirth. Unexplained intrauterine foetal death, hypertensive disease, placenta abruptio was the leading causes of stillbirth. CONCLUSION In this study stillbirth rate seems to be unacceptably high, though less than those reported in other settings. The causal factors associated with it were identified as nulliparity, unexplained intrauterine foetal deaths, hypertensive disease, and placenta abruptio. Because of the high rate of stillbirths reported in this study, it is recommended that interventions be made to introduce fetal autopsies at the tertiary healthcare facilities and that an educational intervention aimed teaching pregnant women be instituted.