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Gelila Kidane Goba Awol Yemane Legesse Anna Whelan Ken Divelbess Erin Cavanaug Sumeya Ahmed Mohammednur Aparna Ramanathan Yibrah Berhe Zelelow Mary Stephenson

Abstract

ABSTRACT
INTRODUCTION: Stillbirth continues to confound scientists and providers, claiming 18.4 per 1000 births globally in 2015. The rate is much higher in low and middle-income countries, including Ethiopia. Stillbirth is tied to maternal age, infection, non-communicable disease, nutrition and lifestyle factors, and inadequate antenatal care. Lack of quality data, including in Demographic and Health Surveys and national vital statistic registries, limits understanding of the causes and possible solutions of stillbirth. OBJECTIVE: To assess the prevalence of stillbirth in Ayder Comprehensive Specialized Hospital. METHODS: We conducted a retrospective chart review of births from January 2014 to May 2015 at Ayder Comprehensive Specialized Hospital, the largest referral hospital in northern Ethiopia. Stillbirth was defined as birth at, or after, 28 weeks’ gestation or fetal weight >1000g without reliable dating with no observable sign of life. For the present study, the data are reported as descriptive statistics. RESULT: A total of 4,582 live births and 315 stillbirths were recorded at Ayder Comprehensive Specialized Hospital over the study period. Removing lethal congenital anomalies, we observed a corrected stillbirth rate of 54.6 per 1000 deliveries. Nearly two-thirds of stillbirths occurred intrapartum. Among stillbirths arriving at Ayder Comprehensive Specialized Hospital with positive fetal heart tone, 36 (44.4%) occurred during the second stage of labor. Nineteen percent of all stillbirths also occurred in transit from a referral institution. Nearly 40% of stillbirths were classified as “unexplained”. CONCLUSION: A significant proportion of stillbirths occurred after arrival or while in transit. Improved identification of high-risk pregnancies with expedited transfer for emergency obstetric care and improved intrapartum care could help decrease the number of stillbirths.
KEYWORDS: Stillbirth, Ayder, Ethiopia, Africa

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