Perinatal audit using the 3-delays model in western Tanzania

Objective: To audit intrapartum fetal and early neonatal deaths of infants weighing >= 2000 g in a regional hospital in western Tanzania. Methods: The 3-delays methodology was applied to a cohort of perinatal deaths from July 2002 to July 2004. Results: The overall perinatal mortality rate in the hospital was 38 per 1000 live births, and in just over half of these cases the birth weight was >= 2000 g. The leading clinicopathologic causes of death were birth asphyxia (19.0%), prolonged or obstructed labor (18.5%), antepartum hemorrhage (11.5%), and uterine rupture (9.0%). First delays occurred in 19.0% of the cases, second delays occurred in 21.5%, and third delays Occurred in 72.5%. Conclusion: For women who delivered in this hospital, most of the Substandard care occurred after admission to the health facility. The improvement of institutional health care may have a significant impact on the decision to attend health institutions and, thereby, reduce first delays. (c) 2009 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.