Placental findings in term singleton stillbirths in a selected public hospital in Mpumalanga Province - descriptive study

Abstract

Background Stillbirth remains a global challenge and traumatic loss to women, families, communities, nurses and society at large despite all efforts made to reduce it. Globally 2.6 to 3 million stillbirths occur each year. Unexplained intrauterine deaths are the most common primary cause of perinatal deaths in South Africa. The placenta plays a key role in maintaining a healthy pregnancy. Malperfusion of the placenta may result in lesions associated with stillbirths. Placental lesions reflect various physical, social and environmental exposures which can be identified during an examination of the placenta. The researcher examined the placentas in singleton-term stillbirths in a single-site descriptive study to describe placental lesions of stillbirths in the selected hospital. Aim and objectives This study describes macroscopical and microscopical placental lesions of stillbirths in a selected public hospital in the eMalahleni sub-district in the Nkangala district in Mpumalanga Province with a perspective on the history of socioeconomic status, nutritional status, lifestyle, and others such as environment and season. Research design and methods A quantitative non-experimental observational descriptive study was conducted by examining the placentas of 89 term stillbirth babies in the labour ward for macroscopic lesions. A questionnaire was used to capture clinical data from patient files on variables of interest related to macroscopic and microscopic lesions for stillbirth cases. IBM SPSS Statistics version 28 package was used to analyse the data. Findings Statistical association and significance were found between the following variables: stillbirth and number of antenatal care visits (0.0035); birth weight and mid-upper arm circumference (0.013); birth weight and maternal vascular malperfusion (0.001); birth weight and birth attendant (0.034); type of stillbirth and birth attendant (0.033); type of stillbirth and previous obstetric history (0.038); cord insertion and smoking/substance abuse (0.012); cord insertion and haemoglobin (0.029); cord length and meconium histiocytes (0.031); cord diameter and syphilis (0.030); placental weight and onset of labour (0.012); placental weight and foetal vascular malperfusion (0.004); colour of membranes and maternal inflammatory response (0.002); colour of membranes and meconium histiocytes (0.000), and colour of membranes and syphilis (0.053).

Significance and Conclusion Examination of the placenta may help to define the causes in more than 90% of stillbirth cases, inform the research and decrease stillbirth rates. Key terms/concepts: Placental findings, placental lesions, term singleton stillbirths, unexplained stillbirths, stillbirth.