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World J Clin Cases. Jul 16, 2015; 3(7): 635-639
Published online Jul 16, 2015. doi: 10.12998/wjcc.v3.i7.635
Scourge of intra-partum foetal death in Sub-Saharan Africa
Adesina OA Adekanbi, Oladapo O Olayemi, Adeniran O Fawole, Kayode A Afolabi
Adesina OA Adekanbi, Oladapo O Olayemi, Adeniran O Fawole, Department of Obstetrics and Gynaecology, University College Hospital, PMB 5116 Ibadan, Nigeria
Kayode A Afolabi, Federal Ministry of Health, PMB 083 Abuja, Nigeria
Author contributions: Adekanbi AOA, Olayemi OO and Fawole AO contributed equally to the conceptualisation, design and writing of the manuscript; Afolabi KA contributed to the manuscript writing and critical revision for intellectual content; the final version publication was jointly written by the authors.
Conflict-of-interest statement: The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Adesina OA Adekanbi, MB, BS, FMCOG, Department of Obstetrics and Gynaecology, University College Hospital, Queen Elizabeth Road, PMB 5116 Ibadan, Nigeria. sinaadekanbi@yahoo.com
Telephone: +234-803-3263396
Received: July 17, 2014
Peer-review started: July 18, 2014
First decision: August 28, 2014
Revised: March 9, 2015
Accepted: April 10, 2015
Article in press: April 14, 2015
Published online: July 16, 2015
Processing time: 375 Days and 3.9 Hours
Abstract

Intra-partum foetal death has been variously defined. However, a definition adopted at a technical consultation in 2006 is employed in this review. The quality of intra-partum care is a crucial factor for pregnancy outcome for both mothers and new-borns. Intra-partum stillbirth is defined as late foetal death during labour, which clinically presents as fresh stillbirth. The largest proportion of the world’s stillbirths occurs in the late preterm, term and intra-partum periods. The Western Pacific region has the greatest reduction in stillbirth with a 3.8% annual decline between 1995 and 2009; however, the annual decline in the African region is less than 1%. Caesarean delivery is still uncommon, especially in rural areas: 1% of births in rural Sub-Saharan Africa and 5% in rural South Asia are by caesarean delivery; 62% of stillbirths occurred during the intra-partum period; 61.4% of stillbirths are attributable to obstetrical complications. Preventive measures aimed at reducing the incidence of intra-partum foetal death entail all measures aimed at improving quality antenatal care and preventing intra-partum asphyxia. This review discusses intra-partum foetal deaths from a Sub-Saharan African perspective. It explores the contribution of research within the region to identifying its impact on new-born health and potential cost-effective policy interventions.

Keywords: Intra-partum; Foetal; Death; Sub-Saharan; Africa

Core tip: Intra-partum foetal death includes intra-uterine deaths that occur within 12 h of delivery of a new-born weighing more than 1000 g, or that had more than 28 wk of gestation, but could not be resuscitated. Sub-Saharan Africa has the lowest recorded decline of intra-partum foetal deaths; however, this region recorded a doubling of her annual rate of reduction to 3.1% during 2000-2011, from 1.5% during 1990-2000. Impacts of research within the region towards improved new-born health and cost-effective policy interventions are examined.