INTRAPARTUM DEATH OF NONMALFORMED FETUSES IN DENMARK AND SWEDEN IN 1991 - A PERINATAL AUDIT

Background. In 1991 the rate of intrapartum death of non-malformed fet uses was higher in Denmark than in Sweden (4.2 vs. 1.9 per 10,000, OR 2.24). However, it is not clear whether this difference reflects poten tially avoidable cases and/or suboptimal care. Material and methods. S hort descriptions were made from medical records of all 50 intrapartum deaths in Denmark and Sweden in 1991. Ten obstetricians, two from eac h of the Nordic countries, reviewed the cases to determine whether (1) intra-uterine death might have occurred before admission, (2) surveil lance and intervention were insufficient, (3) fetal death was potentia lly avoidable by improved obstetric care; and, if so, to suggest ways of improved health care. Results. There was a statistically higher rat e of insufficient care (surveillance and intervention) (high or less d egree) in the Danish cases (66% vs. 55%). The proportion of potentiall y avoidable fetal deaths was also higher in Denmark (59% vs. 52%) alth ough the difference was not statistically significant. Conclusion. The significantly higher rate of intrapartum death of non-malformed infan ts in 1991 in Denmark compared to Sweden might be reduced by improved intrapartum surveillance and interventions.