Mortalidade perinatal hospitalar: classificaçäo dos óbitos do hospital universitário Cassiano Antonio Moraes, Vitória, Espírito Santo (1992-1993)

Studies of perinatal mortality (PNM) are considered by the WHO to be a priority in infant health,since an understanding of the causes of the causes of PNM is a fundamental step toward its prevention.Howerver,the multitude of causes involved in perinatal deaths makes it difficult to classify these deaths according to a primary etiology.Such a classification must be sufficiently simple and reproducible to allow it to be used in an adequate form to generate comparable results in different locations.Among the different classifications propsed,the one by wigglessworth is the best because it meets criteria.Its objective is to reduce the PNM rate (PNMR) through the detection and correction of the problema in perinatal care which contribute to mortality.The Wigglesworth classification has as its basic presumption the stratification on the basis of weight,which as an isolated variable correlates best with PNMR, followed by classification of deaths into five mutually-exclusive groups.In addition it is based on clinical data, precluding the need for autopsy findings,these can be included if available. These five groups are as follows: Group 1-Deaths occurring before labor; Grou 2-Congenital malformations (CM) Grou 3-Conditions related to premature birth/immaturity; Grou 4-Asphyxiation or trauma related to difficult labor; Grou 5-Specific conditions The objective of our study was to identify and classify the problems related to PNM at the Hospital Universitario Cassiano Antonio Moraes (HUCAM) of the Universidade Federal do Espirito Santo. Along with this we aimed to evaluate the feasibility of Wigglesworth classifcation and concordance rate between findings based solely on clinical data and those associated with pathological findings. We also attempted to provide a cross-sectional description of PNM. We studied all 152 perinatal deaths occuring at HUCAM from january, 1992 to December,1993, during which period there were 4171 livre births of babies weighing>1000g. Of the 152 perinatal deaths,89 were stillbom and 63 were early neonatal deaths,corresponding to a stillorn rate of 20.9/1000 early neonatal death rate of 15.1/1000,and PNM of 34.2/1000 single births.The total PMNR stratified according to weight was 171.2/1000 for babies weighing 3000-3999g at birth.The PMNR on the basis of weight was 171.2/1000 newborns of LBW,23.88/1000 for babies of insufficient weight and 8.89/1000 for those weighing 3000-3999 at birth.Eighty-six (56.6%) of the subjects were male and 66 (43.4%) were female.The majority (2/3) of the cases were delivered by caeserian section and 1/3 were delivered vaginally.Of the entire group,76.1% were premature and 70.2% weighed less than 2500g at birth.