Identifying avoidable causes of perinatal deaths in a district hospital in Lesotho

TL;DR

This study identifies avoidable causes of perinatal deaths in a Lesotho hospital and suggests strategies to reduce them.

Contribution

The study provides insights into avoidable factors contributing to perinatal deaths in a district hospital setting in Lesotho.

Findings

Many perinatal deaths were linked to avoidable patient factors like delayed care and poor responses to antepartum haemorrhage.

Medical personnel issues, such as incorrect partograph use and poor documentation, also contributed significantly.

Administrative problems, including lack of ICU beds and resuscitation equipment, were the leading cause of avoidable deaths.

Abstract

Certain determinants can be associated with avoidable perinatal deaths, and audits are needed to establish what these determinants are, and what can be done to prevent such deaths.

The study aimed at identifying and describing determinants associated with avoidable perinatal deaths at a district hospital in Lesotho and strategies to curb their occurrence.

A retrospective descriptive study was conducted using 142 anonymised obstetric records from January 2018 to December 2020. A data collection tool was adopted from the Perinatal Problem Identification Programme. In this tool, avoidable determinants are referred to as ‘factors’ or ‘problems’.

A concerning number of perinatal deaths were secondary to avoidable patient factors, namely a delay in seeking medical care, inappropriate responses to antepartum haemorrhage, and inadequate responses to poor foetal movements. Medical personnel factors are also worth observing, namely incorrect use of partograph, insufficient notes to comment on avoidable factors and ‘other’ medical personnel problems. Ranking highest among administrative problems were the unavailability of intensive care unit beds and ventilators and inadequate resuscitation equipment. Administrative problems accounted for more perinatal deaths than the patient-related factors and medical personnel factors.

There is an urgent need for periodic audits, health education for patients, staff competency and the necessary equipment to resuscitate neonates.

Avoidable determinants associated with perinatal deaths in a district hospital in Lesotho could be identified. This information provides an understanding of what can be done to limit avoidable perinatal deaths.

Figures