Primary causes of total perinatally related wastage at Tygerberg Hospital.

The primary obstetric cause of total perinatally related wastage (TPRW) (i.e. all antepartum or postpartum deaths of infants greater than or equal to 500 g and who died before hospital discharge) was studied in a clearly defined population in the western Cape over a 1-year period. There were 302 deaths from 7,923 singletons and 31 deaths from 65 pairs of twins delivered from patients cared for by Tygerberg Hospital maternity services. Thirty per cent of the deaths were late abortions, 42% stillbirths, 18% early neonatal deaths, 7% late neonatal deaths and 4% perinatally related infant deaths. The major primary obstetric events leading to TPRW in singletons were antepartum haemorrhage (27.8%), spontaneous preterm labour (24.8%), unexplained intra-uterine deaths (11.9%), infections (9.3%) and fetal abnormalities (7.9%). Multiple pregnancies accounted for 9.3% of the TPRW of all deliveries. The cause, risk factors associated and methods of prevention of abruptio placentae, spontaneous preterm labour and infections should receive priority in perinatal research in the western Cape.