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The perinatal mortality has always attracted great interest and this wide interest has been readily explained by the complexity of the biological problems as well as certain definite factors connected with the perinatal period. The present clinical observation of the perinatal mortality at the Obstetric Ward of the National Medical Center, Seoul, during the years of 1968 to 1972, was based upon an obstetrical analysis of all deliveries during this 5 years. During this period there was a total of 6,913 single births with 93 twins and one triplet. Total number of births, therefore, were 7,102 and of these 6,905 were live births. Two hundred and seventy four perinatal deaths occurred throughout the above period. Perinatal mortality comprised all the dead infants with a birth weight above 1,000 gm who had died either before, during labor or in the first 7 days after birth. The results of clinical analysis were summarized as follows : 1. The perinatal mortality rate was 39.7 per 1,000 live births. For the last 2 years the perinatal mortality rate rose about 10 per 1,000 live births mainly due to increase of the neonatal death rate in prematures while the stillbirth rate remained stationary. The early nionatal death rate was 11.2. 2. The perinatal mortality rate was higher in 2 to 5 parity group than in primiparous group and highst in 6 or more. The nionatal death rate was the lowest in 2 to 5 parity group and the highst in 6 or more. 3. The perinatal mortality rate among pleural births were higher than single births. 4. One hundred thirty five babies (49.3%) among 274 perinatal deaths weighted between 1,000∼2,499 g and 139 babies (50.7%) weighed more than 2,500g. There was an inverse relationship between birth weight and mortality rate. 5. Perinatal deaths were more frequent in mothers who had not recieves prenatal care than in mothers who recieved it, even one or more times. 6. The perinatal mortality rate in breech presentation was higher than in cephalic and highst in transverse presentation. In breech presentation the fetuses were more often subject to birth traumas as compaired with ceplalic presentation and the risk of prolapse of the umbilical cord was increased in transverse presentation. Therefore the neonatal death was more frequent breech and the stillbirth rate was highst in transverse presentation. 7. The mode of deliveries were consisted of 72.7% of spontaneous delivery, 12.6% of vacuum extraction, 8.5% of cesarean section, 4.5% of assisted breech delivery, 0.7% of forceps delivery and 1% of moscellaneous modes. The perinatal mortality rate was lowest in the spontaneous delivery group (24.9) and was gradually increased by orders of vacuum extraction 37.6, cesarean section 61.9, assisted breech delivery 77.7 and forceps delivery 148.9. 8. The majority of neonatal deaths occurred within 24 hours after birth (88.3%) and the majority of perinatal deaths occurred during ante or intrapartum (71.9%). 9. The most common cause of perinatal deaths was related to hypoxia (29.6%) of which the most common contributing factor was abruptio placentae. Hypertensive disorders in pregnancy was present in 24.1% of all deliveries with a perinatal mortality rate of 25.5. About half of perinatal deaths were associated with prematurity.
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