Mortality of children before birth and in the first seven days after it is not a new problem. If earlier it could not be solved due to the low quality of obstetric and gynecological care (after all, maternity hospitals appeared only in the 20s of the 20th century, and before that they all gave birth to midwives), now perinatal mortality, namely such a term defines this phenomenon, is closely studied by doctors, statisticians, experts of various organizations.
The very concept of perinatal mortality is the death of a fetus from the twenty-eighth week of fetal development to seven days after the birth of the baby. Currently, all countries have aligned indicators so that statistics can be compared and conclusions drawn. Studying the causes of perinatal mortality is one of the main tasks of physicians. Knowing exactly the reasons, it will be possible to eradicate this phenomenon.
In order to better understand what is at stake, plunge a little into the dry numbers. To calculate the perinatal mortality rate, a fetus or a newborn whose mass is more than one kilogram is taken into account, and if the mass cannot be determined, then metric indicators are taken into account - the body length should be more than thirty-five centimeters, which corresponds to twenty-eight weeks of intrauterine development.
In general statistics, consider a fetus weighing more than half a kilogram, twenty-five centimeters long, during pregnancy 22 weeks. Why are these numbers taken? Since 1993, according to the recommendations of WHO, it is from this period of development that children should be given resuscitation at birth. That is, they are actually recognized as live births, which means that any death of the fetus is considered mortality. This is due to the fact that in the world there are cases of nursing a child with just such a weight and at such a time.
If death occurred after childbirth in the first seven days, or if the child was born dead, but full-term and viable, then the doctors taking the birth are obliged to notify the civil registration authorities about this. When registering perinatal mortality, a medical certificate of a certain pattern is issued. If more than one fetus was born during pregnancy, then such a certificate is compiled for each deceased child. In order to prevent further perinatal mortality, its causes are established using an autopsy, which is mandatory. The final conclusion is issued by the pathologist and how the spine is attached to the certificate.
Among the causes of perinatal mortality, it is worth noting the home birth, which has recently become fashionable. Moreover, women in childbirth often do not think about the fact that home deliveries, in fact, take place without the support of medical personnel, because even the doctors present without the necessary medical resuscitation equipment will not be able to help the child in any way if such a need arises. Sometimes home birth has a criminal connotation when the mother wants to get rid of the baby, causing him specially harm. In this case, the autopsy is performed by a forensic expert. In fact, this is the reason for the trial, because here the full blame lies with the mother, who by her actions did not contribute to the normal course of childbirth.
If the child dies during the first week, then in the registry office he is registered two times: the first time as born, and the second time as dead.
At autopsy, doctors often note fetal abnormalities, the causes of which were mother's diseases, complications during pregnancy, childbirth.
Perinatal mortality is displayed as the ratio of the number of all deaths at the perinatal age to the number of all births, multiplied by a thousand. It is very important to rank for the causes of mortality: from asphyxia, from intrauterine malformations, from pneumonia, and from blood diseases. In order to reduce perinatal mortality, pregnant women are monitored and women at risk (especially infertile, after multiple abortions, suffering from somatic diseases, and old-born) are under special supervision. At the same time, not only doctors, but also the woman herself should be ready for the birth of a healthy child, observe the requirements of the doctor, lead a correct lifestyle, abandon bad habits.