Causal analysis of fetal death in high-risk pregnancies.
J Perinat Med
; 49(6): 740-747, 2021 Jul 27.
Article
in En
| MEDLINE
| ID: mdl-33735952
ABSTRACT
OBJECTIVES:
To determine the causes of fetal death among the stillbirths using two classification systems from 22 weeks of gestation in a period of three years in high-risk pregnancies. This is a retrospective observational study.METHODS:
The National Institute of Perinatal Health in Mexico City is a Level 3 care referral center attending high-risk pregnancies from throughout the country. The population consisted of patients with fetal death during a three-year period. Between January 2016 and December 2018, all stillbirths were examined in the Pathology Department by a pathologist and a medical geneticist. Stillbirth was defined as a fetal death occurring after 22 weeks of gestation.RESULTS:
Main outcomemeasures:
Causal analysis of fetal death using the International Statistical Classification of Disease and Related Health Problems-Perinatal Mortality (ICD-PM) and initial causes of fetal death (INCODE) classification systems. A total of 297 stillborn neonates were studied. The distribution of gestational age in antepartum stillbirths (55.2%) showed a bimodal curve, 36% occurred between 24 and 27 weeks and 32% between 32 and 36 weeks. In comparison, the majority (86%) of intrapartum deaths (44.8%) were less than 28 weeks of gestation. Of the 273 women enrolled, 93 (34%) consented to a complete fetal autopsy. The INCODE system showed a present cause in 42%, a possible cause in 54% and a probable cause in 93% of patients.CONCLUSIONS:
The principal causes of antepartum death were fetal abnormalities and pathologic placental conditions and the principal causes of intrapartum death were complications of pregnancy which caused a premature labor and infections.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Placenta Diseases
/
Pregnancy Complications
/
Congenital Abnormalities
/
Stillbirth
/
Fetal Death
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Adult
/
Female
/
Humans
/
Pregnancy
Country/Region as subject:
Mexico
Language:
En
Journal:
J Perinat Med
Year:
2021
Type:
Article
Affiliation country:
Mexico