ABSTRACT
A multidisciplinary team composed of obstetricians, pediatricians, and pathologists
examined the causes of 453 consecutive perinatal deaths, which occurred between 1978
to 1982. A clear distinction between obstetric diagnosis and infant cause of death
was made, and a principal obstetric and infant diagnosis was assigned to each death.
Perinatal death rates by obstetric category were calculated. The rates varied from
6.1 per 1000 births in uncomplicated cases to 217.4 per 1000 births in isolated intrauterine
growth retardation. The causes of perinatal death within obstetric categories were
tabulated. Nonviability or the complications of prematurity (65%) were the leading
causes of death when there was third-trimester bleeding, premature labor, or premature
rupture of membranes. Anoxia (59%) was the most frequent cause of death when there
was hypertension/pre-eclampsia or other uteroplacental insufficiency states. Death
from congenital abnormality accounted for 17.7% of all perinatal deaths. A focus on
the causes of perinatal death with obstetric diagnostic categories helps weigh the
risk of prematurity versus the risk of anoxia in the management of high-risk gravidas.
