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SM ISO690:2012 BURSACOVSCHI, Natalia, PETROV, Victor, EŢCO, Constantin. Relevant conditions of stillbirth at term. In: Perinatal medicine: XXV European Congress, 15-18 iunie 2016, Amsterdam. Amsterdam, Olanda: 2016, p. 225. ISSN 1476-7058. 10.1080/14767058.2016.1191212 |
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Perinatal medicine 2016 | |||||||||
Conferința "Perinatal medicine. " Amsterdam, Țările de Jos, 15-18 iunie 2016 | |||||||||
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Introduction: Stillbirth cases are the most important adverse outcomes of pregnancy, however poorly understood and recognized [Jay E Lawn et al., 2011]. Intrauterine death of mature fetus justifies up to 50% cases of stillbirth [Stratulat P. et al., 2014]. Many times these deaths are due causes which may be prevented [A. Choudhary, 2014, H. L. Kidanto, 2014]. Reduction of stillbirth at term requires mostly inexpensive interventions [Stratulat P. et al., 2014]. To do this, it is crucial to understand the causes and factors associated with stillbirth [Aminu M. et al., 2014]. Classification helps to identify the probable etiology of fetal deaths and series of events that eventually led to fetal death, as well as to formulate prevention policies and protocols [A. Choudhary, 2014]. Materials and methods: A retrospective case-control study was handled. The sample size was limited by the total number of stillbirths at term (0 Apgar score at the first and fifth minute of life) registered in the Institute of Mother and Child (IMC) of Republic of Moldova during 2013-2014. The control group consisted of live births in the same obstetric units. As mature were considered newborns since 37 obstetric week. The study group (L1) included 39 cases of intrauterine fetal demise at term, the control group (L0) - 69 live births. In order to obtain the necessary information it has been examined the stationary patient chart (Form 000-1/e). Data collection was carried out by means of a specially developed questionnaire. Clinical cases and summary results: The main disease that led to death in utero of mature fetus in IMC according to the ICD-10 was mostly intrauterine fetal hypoxia, present in 61.5% of cases and congenital abnormalities in 18%, intrauterine infection -20,5%. According to the ReCoDe classification, that seeks to identify the condition(s) which existed at the time of death in-utero, approximately half of the cases of intrauterine death are related to fetus pathology (Fig. 1). The last is represented by intrauterine growth retention (17,9%) and congenital abnormality (15%), as well as intrauterine infection (23%), confirmed by the histological examination. It should be mentioned that the majority of the IGR cases were not detected during ante/intrapartum period. Umbilical cord pathology was present in 23% of the cases and placenta related conditions (infarcts or inflammatory damage) -7, 7%. Intrapartum fetal deaths were all due to acute intrauterine asphyxia (n=5). Maternal pathology was presented by hypertensive disorder. Conclusion: According to ICD-10 more than half of mature fetuses died in utero due to acute or chronic intrauterine hypoxia. The conditions that lead to the development of hypoxia vary and become transparent after evaluation by the ReCoDe classification. In most cases, they were related to fetal and umbilical cord pathology, as well as placental dysfunction, intrapartum asphyxia and hypertensive maternal disorder. |
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Cuvinte-cheie stillbirth, relevant condition |
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