A multi-country study of the "intrapartum stillbirth and early neonatal death indicator" in hospitals in low-resource settings

Robert L. Goldenberg, Elizabeth M. McClure, Bhala Kodkany, Gilbert Wembodinga, Omrana Pasha, Fabian Esamai, Antoinette Tshefu, Archana Patel, Hillary Mabaye, Shivaparasad Goudar, Sarah Saleem, Manjushri Waikar, Ana Langer, Carl L. Bose, Craig E. Rubens, Linda L. Wright, Janet Moore, Ann Blanc

Research output: Contribution to journalArticlepeer-review

20 Citations (Scopus)


Objective To determine the feasibility of introducing a simple indicator of quality of obstetric and neonatal care and to determine the proportion of potentially avoidable perinatal deaths in hospitals in low-income countries. Methods Between September 1, 2011, and February 29, 2012, data were collected from consecutive women who were admitted to the labor ward of 1 of 6 hospitals in 4 low-income countries. Fetal heart tones on admission were monitored, and demographic and birth data were recorded. Results Data were obtained for 3555 women and 3593 neonates (including twins). The doptone was used on 97% of women admitted. The overall perinatal mortality rate was 34 deaths per 1000 deliveries. Of the perinatal deaths, 40%-45% occurred in the hospital and were potentially preventable by better hospital care. Conclusion The results demonstrated that it is possible to accurately determine fetal viability on admission via a doptone. Implementation of doptone use, coupled with a concise data record, might form the basis of a low-cost and sustainable program to monitor and evaluate efforts to improve quality of care and ultimately might help to reduce the in-hospital component of perinatal mortality in low-income countries.

Original languageEnglish
Pages (from-to)230-233
Number of pages4
JournalInternational Journal of Gynecology and Obstetrics
Issue number3
Publication statusPublished - Sept 2013


  • Doptone
  • Fetal heart tones
  • Hospital-based perinatal mortality
  • Neonatal mortality
  • Perinatal mortality
  • Stillbirth


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