Identifying avoidable causes of perinatal deaths in a district hospital in Lesotho.
Rose Nonyane, Emmerentia Du Plessis, Jeannette Clase
PMID 38426794WHAT IT FOUND
In 142 perinatal death records, most deaths were stillbirths, and most had at least two or three avoidable problems.
Nurses should monitor foetal movement, labour progress, escalation, and equipment readiness.
Key findings
01The record review included 142 eligible obstetric records, and most of those deaths were stillbirths.
02In most cases, at least two or three avoidable determinants were recorded for a death, and more than one category could be recorded.
03Recorded avoidable determinants included inappropriate response to poor foetal movements, delay seeking care during labour, incorrect partograph use, doctors not responding to calls, and inadequate resuscitation or nursery equipment.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a retrospective audit of records at a district hospital, not a trial or intervention study. The researchers relied on what was written in obstetric records, and some records could not be located. The records often used short codes without detailed explanations, and some categories were left unspecified. The paper gives a design period of January 2018 to December 2021 and an eligibility period of January 2018 to December 2020. Most deaths had two or three avoidable determinants, so the contribution of any single factor cannot be separated. No patients, families, or staff were interviewed, so the reasons behind delays are not described.
Declared interests
The paper states that North-West University provided a study bursary to the first author, R.N. No other funding or conflict-of-interest statement is given.
The easy way to misread this
Do not read this as proof that fixing one factor, such as partograph use or equipment, prevents perinatal deaths. It is a retrospective audit of 142 records at a district hospital, and most deaths had two or three avoidable determinants, so no single cause or intervention can be isolated.