Abstract
Objective: Perinatal mortality rate remains of fundamental inference for identifying problems pertaining to obstetrical and early neonatal treatment. Unit we know how to prevent congenital malformations, obstetrical accidents (abruptio -placentae) and very premature deliveries, we must accept an irreducible minimum perinatal mortality rate. The perinatal mortality rate is a sensitive index of the adequacy and the type of the obstetrical care during pregnancy, labour and neonatal care early in the
puerperium.
Methods: This IS a retrospective study carried in Wad Medani Teaching Hospital, Medani city - Sudan. Case notes were reviewed for all perinatal
deaths and all deliveries during the period 1st January 1985 up to 31st December 1999. This period is subdivided into three periods 1985 -- 1998-
1990-1994-1995-1999. The data were analyzed and the literature is reviewed to compare result of similar studies.
Results: Out of the total number of deliveries during that period (n= 44605) there are 2340 perinatal deaths, giving a total perinatal mortality rate of 76 52.511000 live births. This perinatal mortality rate shows a decline with each period, being 70.31100 during the period 1985 - 1989, 56.811 000 during the period 1990-1994 and 37.311000 during the last period 1995 - 1999. Prematurity is the leading cause of perintal deaths accounting for .2% of cases. The number of preventable perintatal deaths had decreased steadily.
Conclusion: The study highlighted the existence of a very senous health problem. Prematurity, congenital malformation, poor antenatal care, deficient care at delivery, and limited neonatal care facilities are the main contributory factors. Reduction of the perintatal mortality rate is subject to improvement of those main factors, improvement of communal economic, social and educational standards, improvement of data collection and changes in obstetrical and neonatal care.

Key words: Perinatal mortality, Perinatal mortality rate, prematurity, Congenital malformation, neonatal care