Obstetric causes for delivery of very-low-birth-weight babies at Tygerberg Hospital
Objective. To determine the primary reasons for the delivery of very-low-birth-weight (VLBW) babies. Design. Cross-sectional descriptive study. Study period. 1 March 1997 - 31 August 1997. Methods. Data were collected from all mothers who delivered babies weighing 500 - 1499 g. The following primary causes were selected and clearly defined: spontaneous preterm labour, preterm prelabour rupture of membranes, hypertensive disease, antepartum haemorrhage, intrauterine death and congenital abnormalities. A total of 227 patients were admitted to the study. One patient was excluded from the study as the data in her file were inadequate. Of the remaining 226 patients, 210 had singleton pregnancies and 16 had twin pregnancies. In total 242 babies were delivered; however, 6 babies from the twin pregnancies were excluded from the analysis as they had a birth weight exceeding 1 499 g. Results. Primary causes of delivery were hypertensive disease in 101 patients (44.7%), spontaneous preterm labour 65 (28.8%), preterm prelabour rupture of membranes 21 (9.3%), intrauterine death 17(7.5%), antepartum haemorrhage 10 (4.4%), congenital abnormalities 3 (1.3%), and other 9 (4%). Of the hypertensive cases, 43 were delivered for fetal distress, 16 for fetal distress due to abruptio placentae, 20 for material reasons, 19 for intrauterine death and 3 for both fetal and maternal reasons. Conclusion. Hypertention, preterm labour and prelabour rupture of membranes were the main causes of delivery of VLBW babies. Further research should address methods to reduce the number of these deliveries.