OBJECTIVE: To undertake a retrospective perinatal death audit and assessment of avoidable factors associated with stillbirths among a cohort of women in two provinces in Papua New Guinea. METHODS: We used data from an ongoing cluster-randomised crossover trial in 10 sites among 4,600 women in Papua New Guinea (2017-date). The overarching aim is to improve birth outcomes. All stillbirths from July 2017 to January 2020 were identified. The Perinatal Problem Identification Program was used to analyse each stillbirth and review associated avoidable factors. RESULTS: There were 59 stillbirths among 2558 births (23 per 1,000 births). 68% (40/59) were classified ‘fresh’ and 32% ‘macerated’. Perinatal cause of death was identified for 63% (37/59); 30% (11/37) were due to intrapartum asphyxia and traumatic breech birth; and 19% (7/37) due to pre-eclampsia. 95% (56/59) of stillbirths had at least one avoidable factor identified. Patient-associated factors included lack of response to reduced fetal movements and delay in seeking care during labor. Health personnel-associated factors included poor intrapartum care, late diagnosis of breech presentation and prolonged second stage with no intervention. CONCLUSION: Factors associated with stillbirths in this setting could be avoided through a package of interventions at both the community and health facility level.
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