1. Perinatal Pathology: A Review Dr G Mortimer UCHGalway

2. Totals 2003 Mothers: 1,203P 1,941M = 3,144 Mothers: 1,203P 1,941M = 3,144 Babies: 1,223P 1,976M = 3,199 Babies: 1,223P 1,976M = 3,199 Singletons: 1,183P 1,907M = 3,090 Singletons: 1,183P 1,907M = 3,090 Twins: 20P 33M = 53 Twins: 20P 33M = 53 Triplets: 0P 1M = 1 Triplets: 0P 1M = 1

3. Total Babies 1999: 2,704 1999: 2,704 2000: 2,830 2000: 2,830 2001: 3,001 2001: 3,001 2002: 3,218 2002: 3,218 2003: 3,199 2003: 3,199

4. Multiple Births 1999: Twins 48, Triplets 6; Total = 54 1999: Twins 48, Triplets 6; Total = 54 2000: Twins 45, Triplets 0; Total = 45 2000: Twins 45, Triplets 0; Total = 45 2001: Twins 42, Triplets 1; Total = 43 2001: Twins 42, Triplets 1; Total = 43 2002: Twins 56, Triplets 4; Total = 60 2002: Twins 56, Triplets 4; Total = 60 2003: Twins 53, Triplets 1; Total = 54 2003: Twins 53, Triplets 1; Total = 54 2004: Twins 61, Triplets 0; Total = 61 2004: Twins 61, Triplets 0; Total = 61

5. Non-National Deliveries 1999: 18 0.6% 1999: 18 0.6% 2000: 59 2.0% 2000: 59 2.0% 2001: 202 6.8% 2001: 202 6.8% 2002: 361 11.5% 2002: 361 11.5% 2003: 364 11.5% 2003: 364 11.5%

6. Perinatal Mortality Rates 1999 2000 2001 2002 2003 1999 2000 2001 2002 2003 Stillbirths 0.5% 0.8% 0.7% 0.5% 0.7% Stillbirths 0.5% 0.8% 0.7% 0.5% 0.7% NND 0.4% 0.3% 0.2% 0.4% 0.3% NND 0.4% 0.3% 0.2% 0.4% 0.3% Total Rate 0.9% 1.1% 0.9% 0.9% 1.0% Total Rate 0.9% 1.1% 0.9% 0.9% 1.0%

7. Perinatal Loss 2003 Total = 31 Total = 31 21 Antepartum Stillbirths 21 Antepartum Stillbirths 10 Neonatal Deaths 10 Neonatal Deaths

8. Perinatal Deaths Autopsy No Autopsy Autopsy No Autopsy All: 31 17 (55%) 14 (45%) All: 31 17 (55%) 14 (45%) NND: 10 3 (30%) 7 (70%) NND: 10 3 (30%) 7 (70%) SB: 21 14 (66%) 7 (33%) SB: 21 14 (66%) 7 (33%)

9. Perinatal Deaths 2003 Stillbirths: 9P 12M = 21 (0.7%) Stillbirths: 9P 12M = 21 (0.7%) Early NND: 6P 4M = 10 (0.3%) Early NND: 6P 4M = 10 (0.3%) Total: 15P 16M = 31 (1.0%) Total: 15P 16M = 31 (1.0%)

10. Causes Antepartum Deaths Prims Multips Total Prims Multips Total Unexplained 3 9 12 Abruptio 2 1 3 TTS 2 0 2 Cord Accident 1 1 2 IUGR 0 1 1 Malformation 1 0 1

11. Stillbirths UCHG 1973-1992 1973-82 1983-92 1973-82 1983-92 Congenital anomalies 62 31 Congenital anomalies 62 31 Asphyxia 75 20 Asphyxia 75 20 PET 41 5 PET 41 5 Maternal disease 25 7 Maternal disease 25 7 IUGR 55 27 IUGR 55 27 Unexplained 33 60 Unexplained 33 60 Other 30 4 Other 30 4 Total 321 154 Total 321 154

12. Stillbirth Rate/1000 UCHG 1973-1992 1973-82 1983-92 1973-82 1983-92 Congenital anomalies 2.3 1.2 Congenital anomalies 2.3 1.2 Asphyxia 2.7 0.8 Asphyxia 2.7 0.8 PET 1.4 0.2 PET 1.4 0.2 Maternal disease 0.9 0.3 Maternal disease 0.9 0.3 IUGR 2.0 1.0 IUGR 2.0 1.0 Unexplained 1.2 2.37 Unexplained 1.2 2.37 Other 1.1 0.15 Other 1.1 0.15 Total 11.7 5.98 Total 11.7 5.98

13. Causes Neonatal Deaths Prims Multips Total Prims Multips Total Malformations 2 1 3 Malformations 2 1 3 Prematurity 3 0 3 Prematurity 3 0 3 Infection 0 1 1 Infection 0 1 1 TTS 0 2 2 TTS 0 2 2 Abruptio 1 0 1 Abruptio 1 0 1

14. Autopsies 2004 Total : 14 Total : 14 Neonates : 5 Neonates : 5 Stillbirths : 9 Stillbirths : 9

15. Neonatal Autopsies 2004 Twins TTS MoDi Early Twins TTS MoDi Early T2 Premature DiDi/Infarct Early T2 Premature DiDi/Infarct Early RDS Late RDS Late Congenital Anomaly Early Congenital Anomaly Early

16. Stillbirth Autopsies 2004 Unexplained 7 Unexplained 7 Congenital Anomaly 2 Congenital Anomaly 2

17. Unexplained Stillbirths 2004 (8) Twins TTS MoDi Infarction Twins TTS MoDi Infarction T1 DiDi Infarction T1 DiDi Infarction Acute chorioamnionitis + Infarction Acute chorioamnionitis + Infarction Acute chorioamnionitis + SROM Acute chorioamnionitis + SROM Infarct + PET-type maternal vasculopathy Infarct + PET-type maternal vasculopathy

18. Sudden Infant Death Syndrome 2004 2 Cases 2 Cases