STILLBIRTHS: PREVALENCE, RISKS AND CLINICAL INTERVENTIONS IMPACT AMONG WOMEN IN KWAHU GOVERNMENT HOSPITAL
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Background
It is the expectation and joy of every expectant mother and her immediate family to welcome into their fold healthy newborn babies after each gestational period. Unfortunately, in most instances this expectation is marred by complications which ocassionally result in the death of the unborn/newborn child known as stillbirth. This anti-climax leads to unexpected periods of sadness for both mother and her immediate family members. The growing incidence of stillbirths is acknowledged worldwide and said to be associated with many factors both maternal and child health conditions. However, the key question is how many of these maternal and child conditions could have been anticipated and prevented. Addressing this challenge will require a review of specific instutional policy frameworks that deals with the incidence of stillbirths on a case by case basis. In this retrospective study, record of stillbirths over a 5-year period is examined to determine impact of clinical interventions on prevalence and risks among women within Kwahu West municipality in Ghana.
Method
A retrospective cross-sectional study to examine recorded cases of stillbirths over a 5-year period among women in Kwahu South Hospital to determine clinical intervention impact on prevalence, risks and control was undertaken. Using established clinical audit recommendations, this study examines the effectiveness of recommendations and its impact. Socio-demographic features such as age, educational level, gestational maturity, medical conditions of mother and child, delivery method, recorded stillbirth types, fetal sex and patient’s geographical location. All statistical analysis was performed using R programming tool.
Results
Clinical interventions and its impact show a reduction in stillbirth types from 4 to 2 from 2019-2023. However, macerated and fresh stillbirths remain the most dominant stillbirth types recorded with and without medical conditions in urban communities. Sustained decreases in the number of stillbirths across all years including the elimination of early neonatal deaths and intra-uterine fetal deaths from 2021-2023 is observed.
Conclusion
Established institutional clinical audit on each stillbirth occurrence provided in-depth analysis on case-by-case basis. This practice led to the use of clinically designed interventions resulting from audit reviews on specific cases to help address similar situations. Even though a reduction in the number of recorded stillbirths from 20.83 per 1000 live births in 2019 to 10.81 per 1000 live births in 2023 is noted, a staggering 76.88% share of stillbirths among patients and fetus with no medical condition presents a serious challenge to healthcare providers. Detailed review of all cases that excludes nothing irrespective of clinical presentation can provide important insight into the incidence of high stillbirth rates among women with such presentation.
