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Journal articles on the topic 'Fetal death Risk factors'

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Published: 10 December 2022
Last updated: 29 January 2023

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1

Aquino, Márcia Maria Auxiliadora de, José Guilherme Cecatti, and Coríntio Mariani Neto. "Risk factors associated to fetal death." Sao Paulo Medical Journal 116, no. 6 (November 1998): 1852–57. http://dx.doi.org/10.1590/s1516-31801998000600005.

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OBJECTIVE: The purpose of this study was to investigate risk factors associated to fetal death in a Brazilian population. DESIGN: A case control study. SETTING: The Hospital Maternidade Leonor Mendes de Barros in São Paulo. PARTICIPANTS:122 pregnant women with diagnosis of fetal death and gestation age of 20 or more weeks and 244 controls of pregnant women who delivered liveborns. VARIABLES STUDIED: The fetal death (dependent variable), independent variable (the social demographic factors, clinical and obstetrical history, prenatal care indicators and pathological conditions). RESULTS: The risk factors associated to fetal death were abruptio placentae, syphilis, few prenatal care visits, one or more previous stillbirths, hospitalization during pregnancy, diabetes, age above or equal to 25 years, hypertension during pregnancy, anemia and age below 20 years. CONCLUSIONS: Results of the current study might be useful to orientate a primary prevention health program, specially those concerning antenatal care.
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2

Sheiner, E., M. Hallak, T. Oron, T. Silberstein, I. Shoham-Vardi, M. Katz, and M. Mazor. "Antepartum fetal death: obstetrical risk factors." International Journal of Gynecology & Obstetrics 70 (2000): C93. http://dx.doi.org/10.1016/s0020-7292(00)80630-x.

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3

Thakur, Achala, Pritha Basnet, Rubina Rai, and Ajay Agrawal. "Risk Factors Related to Intrauterine Fetal Death." Journal of Nepal Health Research Council 17, no. 01 (April 28, 2019): 46–50. http://dx.doi.org/10.33314/jnhrc.v17i01.1534.

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Background: Intrauterine fetal death is a traumatic event. Stillbirth rate is an important indicator to assess the quality of antenatal care. The objective of the study was to identify the risk factors related to intrauterine fetal death in patients admitted with intrauterine fetal death.Methods: It was a descriptive study conducted in the department of Obstetrics and Gynaecology at B. P. Koirala Institute of Health Sciences from January to December 2014. Patients admitted with singleton pregnancy with intrauterine fetal death after 28 weeks gestation were included. Results: There were 11,006 obstetric admissions. Of them, 152 women had intrauterine fetal death. There were 128(84.2%) women between 20-35 years of age. Out of 152, 81(53.3%) women were preterm and 39(2.1%) women were postterm. Primigravida were 77(50.7%) followed by 35(23%) of second gravida. Hypertension was the commonest identified risk factor in 30(26.78%) women. Out of 152 women, 49(32.2%) had not received formal education. Ten (6.6%) women had a past history of fetal death. Four (2.6%) women had medical disorder before pregnancy. One hundred and twenty five (82.2%) women had vaginal delivery, 21(13.8%) had caesarean section and 6(3.9%) had laparotomy for rupture uterus. The commonest indication for caesarean section was placenta previa for 7(33.33%) women. Four (2.6%) women had diabetes. Ninety five (62.5%) were male and 57(37.5%) were female babies. Five (3.3%) babies had malformations. Conclusions: Hypertension in pregnancy was found to be the most common identified risk factor for intrauterine fetal death. Keywords: Fetal death; pregnancy; risk factors.
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4

Válková, Andrea, and Petr Hubka. "Covid-19 as a possible risk factor of intrauterine fetal death." Česká gynekologie 86, no. 6 (December 21, 2021): 410–13. http://dx.doi.org/10.48095/cccg2021410.

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Objective: To summarize information about possible effects of covid-19 on intrauterine fetal death and present three cases of intrauterine fetal death in women with recent covid-19 infection. Methods: Review of available information about pregnancy with covid-19 and comparison with own observation of cases during spring 2021. Conclusion: Covid-19 influences risk of intrauterine fetal death, preeclampsia/eclampsia or HELLP syndrome. Coagulation changes and drop of platelets is considered as one of the causes of intrauterine fetaldeath due to fetal vascular malperfusion. Key words: covid-19 – intrauterine fetal death – obstetrics
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5

Zhang, Jun, and Wen-wei Cai. "Risk factors associated with antepartum fetal death." Early Human Development 28, no. 3 (March 1992): 193–200. http://dx.doi.org/10.1016/0378-3782(92)90166-e.

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6

Zhang, J., and W. W. Cai. "Risk factors associated with antepartum fetal death." International Journal of Gynecology & Obstetrics 39, no. 4 (December 1992): 367. http://dx.doi.org/10.1016/0020-7292(92)90308-6.

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7

Ohana, Oded, Gershon Holcberg, Ruslan Sergienko, and Eyal Sheiner. "Risk factors for intrauterine fetal death (1988–2009)." Journal of Maternal-Fetal & Neonatal Medicine 24, no. 9 (February 11, 2011): 1079–83. http://dx.doi.org/10.3109/14767058.2010.545918.

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8

Almeida, Marcia Furquim de, Gizelton Pereira Alencar, Hillegonda Maria Dutilh Novaes, Ivan França Jr, Arnaldo Augusto Franco de Siqueira, Oona M. R. Campbell, Daniela Schoeps, and Laura Cunha Rodrigues. "Risk-factors for antepartum fetal deaths in the city of São Paulo, Brazil." Revista de Saúde Pública 41, no. 1 (February 2007): 35–43. http://dx.doi.org/10.1590/s0034-89102007000100006.

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OBJECTIVE: To assess risk factors for antepartum fetal deaths. METHODS: A population-based case-control study was carried out in the city of São Paulo from August 2000 to January 2001. Subjects were selected from a birth cohort from a linked birth and death certificate database. Cases were 164 antepartum fetal deaths and controls were drawn from a random sample of 313 births surviving at least 28 days. Information was collected from birth and death certificates, hospital records and home interviews. A hierarchical conceptual framework guided the logistic regression analysis. RESULTS: Statistically significant factors associated with antepartum fetal death were: mother without or recent marital union; mother's education under four years; mothers with previous low birth weight infant; mothers with hypertension, diabetes, bleeding during pregnancy; no or inadequate prenatal care; congenital malformation and intrauterine growth restriction. The highest population attributable fractions were for inadequacy of prenatal care (40%), hypertension (27%), intrauterine growth restriction (30%) and absence of a long-standing union (26%). CONCLUSIONS: Proximal biological risk factors are most important in antepartum fetal deaths. However, distal factors - mother's low education and marital status - are also significant. Improving access to and quality of prenatal care could have a large impact on fetal mortality.
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9

Theodorou, Dimitrios A., George C. Velmahos, Irene Souter, Linda S. Chan, Pantelis Vassiliu, Raymond Tatevossian, James A. Murray, and Demetrios Demetriades. "Fetal Death after Trauma in Pregnancy." American Surgeon 66, no. 9 (September 2000): 809–12. http://dx.doi.org/10.1177/000313480006600901.

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Trauma in pregnancy places the mother and fetus at risk. The objective of this study is to identify risk factors independently associated with acute termination of pregnancy and/or fetal mortality after trauma. The medical and trauma registry records of 80 injured pregnant patients were reviewed. Data were collected and then analyzed by univariate and multivariate analysis. Three patients died (3.7%), 23 had the pregnancy acutely terminated (30%), and 14 suffered fetal death (17.5%). The only independent risk factors for fetal mortality were an Injury Severity Score (ISS) ≥9 and a nonviable pregnancy (<23 weeks). The combination of both risk factors increased the likelihood of fetal mortality by fivefold over that of patients without either risk factor. Maternal hemodynamic parameters did not predict fetal loss. Two patients lost their fetuses despite insignificant trauma (ISS = 1) and normal hemodynamic parameters, whereas eight delivered normal babies despite major trauma (ISS ≥ 16). Hemodynamic stability on admission does not predict fetal mortality. Although the presence of moderate to severe injuries (ISS ≥ 9) increases the likelihood of fetal mortality, this complication may occur even with insignificant trauma. Close maternal and fetal monitoring is justified, regardless of maternal hemodynamic presentation or severity of injury.
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10

Ohana, Oded, Gershon Holcberg, Ruslan Sergienko, and Eyal Sheiner. "702: Risk factors for intrauterine fetal death (1988-2009)." American Journal of Obstetrics and Gynecology 204, no. 1 (January 2011): S278. http://dx.doi.org/10.1016/j.ajog.2010.10.724.

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11

K., Ashok Kumar, Ravindra Kanakeri, and Bharathi Anjanappa. "Clinical study of various risk factors associated with intrauterine fetal death." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 12 (November 23, 2017): 5293. http://dx.doi.org/10.18203/2320-1770.ijrcog20175231.

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Background: The death of a fetus is one of the unhappy events in the field of obstetrics. It is really distressing when it occurs without warning in a pregnancy that has previously entirely normal. It is thus vital to identify specific probable causes of fetal death to determine the risk of recurrence, prevention or corrective action.Methods: A prospective observational study was conducted in ESIC MC and PGIMSR, Rajajinagar, Bangalore, Karnataka, India. All cases of intrauterine fetal death confirmed either with ultrasound or on clinical examination by absence of fetal heart rate and fetal movements were studied. The age, parity, literacy, socio-economic status was recorded. Detailed history, clinical examination, associated conditions. Mode of delivery and details of the fetus and their placentas were noted. They were followed for 3 days for complications.Results: Mean maternal age was 26.03yrs, 98.5% of the women were booked cases, 82% belonged to lower middle class.16.39% of the women had hypertensive disorder of pregnancy, 4.91% had gestational diabetes, 9.8% had abruption placentae, 9.8% had oligohydramnios and 1.63% had polyhydramnios 4.9% were Rh isoimmunisation, 1.9% had twin pregnancy, 3.27% had PROM, 6.6% had cord accidents, 21% had anomalous fetus, 3.27% foetuses had non immune hydrops, 19.67% of IUDs were unexplained.Conclusions: Unexplained causes, PIH and abruptio placentae were major causes of IUFD. Significant proportion of IUFD due to PIH and abruption placenta is preventable by regular antenatal care and timely intervention. Despite advances in diagnostic and therapeutic modalities large number of fetal deaths remain unexplained. Poverty, illiteracy, unawareness and inaccessibility may be some of the reasons for unexplained IUFD.
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12

Ivanov, I., E. Lyashenko, Natalya V. Kosolapova, M. Cheripko, E. Prochan, and A. Lyashenko. "ANTENATAL FETAL DEATH: UNSOLVED PROBLEMS." Tavricheskiy Mediko-Biologicheskiy Vestnik 23, no. 1 (October 18, 2022): 37–41. http://dx.doi.org/10.29039/2070-8092-2020-23-1-37-41.

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The paper presents the results of the retrospective analysis of data cards and histories of 953 women with an antenatal fetal death during 2010-2016 in the Crimea Republic. The aim of the research was to study the data of parity, gynecological and somatic history, features of pregnancy and childbirth in women with antenatal fetal death to identify significant risk factors for this pathology. According to the results of our study, women with antenatal losses did not reveal significant clinical and anamnestic risk factors for adverse perinatal outcomes. This once again confirms the lack of reliable methods for predicting antenatal fetal death in modern practical obstetrics. In spite of the significant progress made in the emergency protection of the child, the stillbirth is an important, insufficiently studied problem in the obstetrics. The high frequency of cases of antenatal fetal death with an unexplained cause requires further in-depth analysis and study of this problem, searching for the possibility of expanding the diagnostic potential of the methods used.
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Morales de Machín, Alisandra, Karelis Urdaneta, Lisbeth Borjas, Karile Méndez, Enrique Machín, and Ana Bracho. "Factores de riesgo genético y diagnóstico prenatal." Revista de Obstetricia y Ginecología de Venezuela 81, no. 03 (September 25, 2021): 209–25. http://dx.doi.org/10.51288/00810305.

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Objective: To identify genetic risk factors and frequency and to describe congenital defects of the fetus. Methods: The research was conducted at the Genetic Research Institute of the Faculty of Medicine. University of Zulia. Maracaibo. We studied patients who attend to the prenatal genetic clinic. According to the Genetic risk factors Identified, it indicated different prenatal diagnostic procedures: fetal echography, fetal echocardiography, triple maternal serum marker, amniocentesis for fetal karyotype and molecular analysis. Results: We included 568 patients. 79.05% of the total showed only one genetic risk factor and the 20.95% two or more. The advanced maternal age was the most frequent genetic risk factor found (40.85%), followed by first-degree family history with a congenital defect (35.21%), abnormal fetal echography (13.73%), exposure to teratogenic agents (10.39%), history of recurrent abortion (7.04%), history of fetal death (4.22%), consanguinity (1.93%), and history of neonatal death (1.76%). They were diagnosed 101 fetuses with congenital defects, one balanced translocation, two fetal deaths and 26 spontaneous abortions. Conclusion: The genetic risk factors identification, served as a starting point to indicate prenatal diagnostic procedures allowed a health evaluation of the fetus and adequate genetic counseling. Key words: Prenatal diagnosis, Risk factors, Genetic counseling.
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14

Kamilova, Markhabo, Parvina Dzhonmakhmadova, and Farangis Ishan-Khodzhaeva. "ASSESSMENT OF RISK FACTORS AND DETERMINING THE LEVEL OF PREVENTABLE FETAL DEATH IN WOMEN WITH TROUBLED PREGNANCY." Avicenna Bulletin 22, no. 1 (March 1, 2020): 14–21. http://dx.doi.org/10.25005/2074-0581-2020-22-1-14-21.

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Objective: To examine the risk factors of stillbirth in the Republic of Tajikistan. Methods: Maps of individual observation of the course of pregnancy and the history of births of women with antenatal and intranatal fetal death in institutions of III and II levels have been studied. Retrospectively has been conducted the clinical audit of 187 cases of stillbirth. Results: The main causes of stillbirths were intrauterine growth retardation syndrome and fetal malformations. The most common risk factors for stillbirth were factors associated with inadequate medical care and factors related to family and women. At the same time, most of the cases of antenatal fetal death (83%) and intranatal fetal death (74%) were preventable or conditionally preventable. Conclusions: Our research confirms the need for perinatal audit, which aims to find the causes and risk factors of stillbirth with the subsequent implementation of solutions to prevent such cases of stillbirths in the future. Keywords: Stillbirths, antenatal fetal death, intranatal fetal death, classification of the ReCoDe, risk factors, levels of, levels of preventable stillbirth
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15

Suverneva, A. A., and I. V. Ignatko. "Current approach to perinatal risk stratification." Voprosy ginekologii, akušerstva i perinatologii 20, no. 4 (2021): 69–77. http://dx.doi.org/10.20953/1726-1678-2021-4-69-77.

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Objective. To develop a new approach to perinatal risk stratification based on the determination of prognostic criteria for antepartum and intrapartum fetal death, and early neonatal death to improve the efficiency of predicting adverse perinatal outcomes. Patients and methods. A retrospective case-control study with the participation of patients with antepartum (n = 134) and intrapartum (n = 41) fetal death, early neonatal death (n = 61), and favorable perinatal outcome (n = 50) was carried out. The Bayes–Wald–Gubler method was used to determine prognostic criteria. Comparative evaluation of the efficacy of the proposed prognostic method and the generally accepted determination of perinatal risk was performed retrospectively in patients with perinatal loss (n = 102) and favorable perinatal outcome (n = 100); ROC analysis was performed. Results. Forty-two risk factors were identified and divided into three groups: universal for all types of perinatal loss, common for two of them, and specific for each of them (antepartum and intrapartum fetal death, early neonatal death). The prognostic value of factors in their presence and absence was determined. It was found that universal and common risk factors for each type of perinatal loss had different prognostic value. The method of differential prediction of perinatal loss was presented. The sensitivity of the new and generally accepted prognostic methods was 95.1 and 69.6%, the specificity was 80 and 53%, and the accuracy of predicting adverse outcomes was 87.6 and 61.4%, respectively. Conclusion. The conducted study allowed to suggest a new approach to perinatal risk stratification based on differential prediction of perinatal loss, which is superior to the traditional risk assessment methods in terms of the effectiveness of predicting adverse perinatal outcomes. Key words: antepartum fetal death, intrapartum fetal death, perinatal outcomes, prediction, early neonatal death
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H. K, Somashekar. "RETROSPECTIVE STUDY OF RISK FACTORS IN PATIENTS WITH INTRAUTERINE DEATHS AFTER THE STATE OF VIABILITY REFERRED TO THE TERTIARY HEALTH FACILITY IN KODAGU." YMER Digital 21, no. 08 (August 9, 2022): 369–73. http://dx.doi.org/10.37896/ymer21.08/32.

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IUFD is an important indicator of maternal and perinatal Health in a given population. Fetal death from Intra partum asphyxia and Rh is immunization has almost disappeared. Toxaemia and GDM contribute significantly to fetal deaths. There is a significant decline in still birth from unexplained causes. Most frequent reported causes of fetal death earlier were prolapsed of cord, abruptioplacenta, Hydrocephalus and rupture uterus. If the causes of IUFD can be found, an effective strategy for prevention of IUFD can be materialised and complications can be prevented. Methods: Retrospective study in Tertiary Care Hospital. Results: 35 out of 38 of the patients are belong to the age group of 20-30 years. With history of reduced fetal moments, background of pre ecclampsia and anaemia contribute significantly to fetal deaths. Conclusions: to seek treating physicians with history of reduced fetal moments and aggressive treatment of PIH and anaemia can reduce the burden of IUD in this tribal belt. Illiteracy is a big burden to train and educate women to seek good antenatal care and advice. Keywords: Pre Ecclampsia Hypertention(PIH), Intra Uterine Fatal Death(IUFD), Anti Partum Haemorrhage(APH), Macerated Still Birth(MSB), Preterm Labour(PTL), Meconium Stained Liquor (MSL), Gestational Diabetes Mellitus(GDM), Pre matured rupture of Membranes(PROM), Lower Segment caesarean section(LSCS), Pre term death (PTD), Congenital Malformations(CMF).
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17

Sinha, Kavita, and Subhash Pandey. "Risk Factors in Patients with Intrauterine Fetal Death at Tertiary Referral Centre." Journal of Nepalgunj Medical College 17, no. 2 (December 31, 2019): 14–16. http://dx.doi.org/10.3126/jngmc.v17i2.28752.

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Background: Among various community health indicators available for measurement of quality and impact of health services in developing countries, perinatal mortality accounts one of the top most single indicators even today. Documentation and evaluation of the etiology and the associated risk factors for stillbirth is required in order to decrease the fetal mortality rate and to devise plan in maternal health sector. Objective: To find out common risk factors in patient and its association with intrauterine fetal death. Methods: A hospital based cross-sectional study carried out in the Department of OBSGYN, Nepalgunj Medical College, Kohalpur from Jan 2018 to September 2019.Cases of multiple pregnancies, intrapartum death and fetal death diagnosed before 28th weeks of gestation were excluded. After exclusion, 65 cases of intrauterine fetal death were studied. Results: Majority (78.4%) of the patients with IUFD belonged to the reproductive age group(20-35yrs) and (15.4%) belong to <19yrs (p=0.008) associated with illiteracy (84.6%). More than half (58.5%) had at least one ANC visit and were primigravida (17%) with preterm (63.07%). Hypertensive disorder was the commonest obstetric complication in these mothers (36.92%) followed by unexplained (26.15%), anaemia (18.46%), PROM (15.4%), APH (13.8%). Most of the babies were low birth weight (63.69%) and majority were males (63.1%). Conclusion: Majority of the risk factors found in the present study were preventable. Stillbirth rate can be reduced by proper management of these risk factors during antenatal care and intrapartum care.
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Foumane, Pascal, Aicha Chumbe Mounton, Julius Dohbit Sama, Séraphin Nguefack, Walter Dobgima Pisoh, and Emile Telesphore Mboudou. "Risk factors of intrapartal fetal death in a low-resource setting." Open Journal of Obstetrics and Gynecology 04, no. 03 (2014): 101–4. http://dx.doi.org/10.4236/ojog.2014.43018.

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Rasmussen, Svein, Susanne Albrechtsen, Lorentz M. Irgens, Knut Dalaker, Helga Maartmann-Moe, Ljiljana Vlatkovic, and Trond Markestad. "Risk factors for unexplained antepartum fetal death in Norway 1967–1998." Early Human Development 71, no. 1 (February 2003): 39–52. http://dx.doi.org/10.1016/s0378-3782(02)00111-1.

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20

HERSCHEL, M., H. HSIEH, R. MITTENDORF, B. KHOSHNOOD, R. COVERT, and K. LEE. "Risk factors for fetal death in white, black, and hlspanic women." Obstetrics & Gynecology 85, no. 2 (February 1995): 318. http://dx.doi.org/10.1016/s0029-7844(95)80186-3.

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21

Brailovschi, Yaniv, Eyal Sheiner, Arnon Wiznitzer, Poria Shahaf, and Amalia Levy. "Risk factors for intrapartum fetal death and trends over the years." Archives of Gynecology and Obstetrics 285, no. 2 (July 7, 2011): 323–29. http://dx.doi.org/10.1007/s00404-011-1969-8.

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22

Zakharenkova, T. N., and M. A. Santalova. "THE CLINICAL AND MORPHOLOGICAL PARALLELS IN ANTENATAL FETAL DEATH." Health and Ecology Issues, no. 3 (September 28, 2017): 18–24. http://dx.doi.org/10.51523/2708-6011.2017-14-3-4.

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Objective: to reveal significant clinical and demographic risk factors and pathomorphological features of the placenta in women with antenatal fetal death. Material and methods. The study included the retrospective analysis of 177 case histories of female patients who were delivered at the medical institutions of the city of Gomel within 2012-2016. The main group consisted of 87 women with antenatal fetal death at various gestational age. The comparison group included 90 women with a favorable pregnancy outcome. Results. The study has revealed pregravid risk factors of antenatal fetal death and the specific features of the course of pregnancy in women with antenatal fetal death: threat of abortion, chronic placental insufficiency, low placenta, polyhydramnios, fetal development delay syndrome, inflammatory diseases of the genitourinary system, anemia, hypertensive disorders, pathomorphological features of the placenta (chronic placental insufficiency, placental hypoplasia, pathologically immature placenta, signs of ascending and hematogenic pathways of infection of the feto-placental system). Conclusion. Multiple factors of antenatal fetal death require a detailed analysis of each case of this pathology with the development of actual models of prevention and prognosis.
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Lydon-Rochelle, Mona T., Vicky Cárdenas, Jennifer L. Nelson, Kay M. Tomashek, Beth A. Mueller, and Thomas R. Easterling. "Validity of Maternal and Perinatal Risk Factors Reported on Fetal Death Certificates." American Journal of Public Health 95, no. 11 (November 2005): 1948–51. http://dx.doi.org/10.2105/ajph.2004.044305.

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24

Yu, H., Q. Yao, R. Zhou, X. Wang, and W. Zeng. "O1036 Risk factors analysis of intrauterine fetal death in the third trimester." International Journal of Gynecology & Obstetrics 107 (October 2009): S388. http://dx.doi.org/10.1016/s0020-7292(09)61409-0.

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Yadav, Nishant, and Sachin Damke. "Study of risk factors in children with birth asphyxia." International Journal of Contemporary Pediatrics 4, no. 2 (February 22, 2017): 518. http://dx.doi.org/10.18203/2349-3291.ijcp20170701.

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Background: Birth asphyxia is a serious clinical problem worldwide and contributes greatly to neonatal mortality and morbidity. Perinatal asphyxia is the fifth largest cause of under-5 deaths (8.5%) after pneumonia, diarrhea, neonatal infections and complications of preterm birth. Risk factors of birth asphyxia have been divided into antepartum, intrapartum and fetal. Risk factors include increasing or decreasing ma-ternal age, prolonged rupture of membranes, meconium stained fluid, multiple births, non-attendance for antenatal care, low birth weight infants, malpresentation, augmentation of labour with oxytocin, antepartum haemorrhage, severe eclampsia and pre-eclampsia, ante partum and intrapartum anemia. The objective of this study was to study the risk factors in children with birth asphyxia.Methods: Observational prospective study was conducted on babies delivered in our hospital and requiring resuscitation (basic and/or advanced). Their clinical course was observed and studied in NICU till time of discharge or death. Detailed maternal history was taken for risk factors.Results: The mean age of mothers was 24.28 years which ranged from 20 years to 29 years. Most of the population was from the lower middle and upper lower socioeconomic status as per the Modified Kuppuswamy scale. 51% neonates were born to primiparous mothers. Anemia was widely prevalent in the moth-ers of neonates requiring resuscitation. The maternal risk factors for newborns requiring resuscita-tion were PIH (23.7%) , oligohydramnios (15%),multiple gestation (3.75 %), PROM (2.5%), diabetes mellitus (2.5%) and UTI (2.5%).One third of neonates requiring resuscitation were born to unbooked mothers.In the neonates requiring resuscitation, the male to female ratio was 1:1. The fetal factors associated with resuscitation of newborns were IUGR (33.75%), fetal distress (31.25%), prematurity (26.25%), MAS (12.5%) and malpresentations (5%).Conclusions: The most common maternal risk factors for newborns requiring resuscitation was PIH followed by oligohydramnios, multiple gestation, PROM, diabetes mellitus and UTI.IUGR was the most com-mon fetal risk factor followed by fetal distress, prematurity, MAS and malpresentations. One third of neonates requiring resuscitation were born to unbooked mothers. In There was no gender predomi-nance found in this study.
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Mufti, Asma Hassan, Samiya Mufti, and Nasir Jeelani Wani. "Intrauterine fetal death associated socio-demographic factors and obstetric causes: a retrospective study." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 10 (September 25, 2020): 4027. http://dx.doi.org/10.18203/2320-1770.ijrcog20204281.

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Background: The death of a fetus is emotionally traumatic for the parents. It is also distressing for the treating obstetrician. Besides being emotionally challenging, fetal demise raises a lot of questions and increases an obstetrician’s medicolegal risk. The aim of this study was to identify various maternal conditions and socio-demographic factors associated with fetal death and to find the preventable causes of fetal death.Methods: A retrospective observational study was undertaken at Lalla Ded Hospital, Srinagar, Kashmir - a tertiary care centre. The cases of singleton intrauterine fetal deaths (IUFD) with either ultrasound reports proving IUFD or diagnosed on clinical examination by absence of fetal heart sound with gestational age >28 weeks were included. Exclusion criteria includes molar pregnancy and multiple pregnancy.Results: Still birth rate in our study was 19.6 per 1000. Most of the patients with stillbirth belonged to age group of 21-30 years accounting for 67.1% of all cases. Unbooked cases comprised of 58.9%. Most of the study patients i.e. 74.7% belonged to lower middle class. In our study 39% of stillbirth cases were in the range of 28-32 gestational weeks followed by 33.6% cases in 33-37 gestational weeks. Maternal hypertensive disorders had a strong association with IUFD 33.6% (pre-eclampsia 27.4%, eclampsia 6.2%). This was followed by placental abruption comprising 11.7%. Gestational diabetes and severe anaemia accounted for 6.2% and 3.4% respectively. Gross congenital anomalies and fetal infections contributed 2.7% and 2% respectively.Conclusions: Routine antenatal checkups with identification of high risk pregnancies, better access to emergency obstetric care especially during labor, emphasis on institutional deliveries community birth attendant training should help in reducing stillbirth rates in developing countries. Optimal evaluation for future pregnancy is necessary. Counseling and support group should be involved.
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Litwinska, Ewelina, Magdalena Litwinska, Bartosz Czuba, Agnieszka Gach, Sebastian Kwiatkowski, Przemyslaw Kosinski, Piotr Kaczmarek, and Miroslaw Wielgos. "Amniocentesis in Twin Pregnancies: Risk Factors of Fetal Loss." Journal of Clinical Medicine 11, no. 7 (March 31, 2022): 1937. http://dx.doi.org/10.3390/jcm11071937.

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This study aims to determine if second trimester amniocentesis in twin pregnancies provides a significant independent contribution in the prediction of miscarriage or fetal loss at any stage of pregnancy. This was a retrospective cohort study of women with twin gestations booked for routine prenatal care in four fetal medicine units in Poland in the years 2010–2020. The study population included: (1) twin pregnancies that underwent amniocentesis at 16–20 weeks’ gestation; (2) twin pregnancies that did not require any further testing and were followed-up routinely. Univariable and multivariable regression analysis was used to define which maternal and pregnancy characteristics provided a significant independent contribution in the prediction of miscarriage and fetal loss at any stage of pregnancy. In the study period, 2645 twin pregnancies were eligible for analysis. There were 144 cases of miscarriage defined as fetal loss of one or both twins before 24 weeks and 40 cases of intrauterine death of one or both twins after 24 weeks. A total number of 162 twin pregnancies underwent amniocentesis at 16–20 weeks’ gestation. The rate of miscarriage before 24 weeks and the rate of fetal loss at any stage of pregnancy in the group that underwent amniocentesis was 10.49% and 13.58%, respectively, compared to 5.11% and 6.52% that did not undergo amniocentesis. Multivariable regression analysis showed that factors providing a significant independent contribution in the prediction of miscarriage and fetal loss at any stage of pregnancy were monochorionicity (MC), large intertwin discordance in crown-rump length (CRL), low Pregnancy Related Plasma Protein (PAPP-A) MoM and nuchal translucency (NT) above 95th centile. Amniocentesis in twin pregnancies does not provide a significant contribution in the prediction of miscarriage or fetal loss at any stage of pregnancy.
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Ishida, Hidekazu, Yukiko Kawazu, Futoshi Kayatani, and Noboru Inamura. "Prognostic factors of premature closure of the ductus arteriosus in utero: a systematic literature review." Cardiology in the Young 27, no. 4 (June 20, 2016): 634–38. http://dx.doi.org/10.1017/s1047951116000871.

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AbstractBackgroundA number of case reports show various outcomes of premature closure of the ductus arteriosus in utero, including persistent pulmonary hypertension of the newborn and fetal or neonatal death; however, no study clarifies the clinical observations that are related to their prognoses. We aimed to clarify the prognostic factors of intrauterine ductal closure by a systematic literature review.Data sourcesWe searched PubMed database (1975–2014) to identify case reports and studies on intrauterine closure of the ductus arteriosus, including maternal, fetal, and neonatal clinical information and their prognoses.ResultsWe analysed the data of 116 patients from 39 articles. Of these, 12 (10.3%) died after birth or in utero. Fetal or neonatal death was significantly correlated with fetal hydrops (odds ratio=39.6, 95% confidence interval=4.6–47.8) and complete closure of the ductus arteriosus (odds ratio=5.5, 95% confidence interval=1.2–15.1). Persistent pulmonary hypertension was observed in 33 cases (28.4%), and was also correlated with fetal hydrops (odds ratio=4.2, 95% confidence interval=1.3–4.6) and complete closure of the ductus arteriosus (odds ratio=5.5, 95% confidence interval=1.6–6.0). Interestingly, maternal drug administration was not correlated with the risk of death and persistent pulmonary hypertension.ConclusionsFetal hydrops and complete ductal closure are significant risk factors for both death and persistent pulmonary hypertension. Cardiac or neurological prognoses could be favourable if the patients overcome right heart failure during the perinatal period.
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Pavlovic, Ivan, Darko Plecas, Snezana Plesinac, Jelena Dotlic, and Nemanja Stojanovic. "Congenital anomalies: Occurrence and potential risk factors." Vojnosanitetski pregled 77, no. 3 (2020): 317–23. http://dx.doi.org/10.2298/vsp180320088p.

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Background/Aim: Congenital malformations still represent one of the most important causes of prenatal and infant death. The study goal was to analyze occurrence and outcomes of different types of congenital anomalies from the tertiary referral center during a ten-year period. Moreover, study aimed at examining potential predictors of congenital anomalies based on patients? characteristics and medical history data. Methods: Study included all pregnant women directed to Clinic of Obstetrics and Gynecology Clinical Center of Serbia due to prenatally diagnosed congenital fetal anomalies during past ten years. Upon admission to our clinic a detailed general medical and obstetrical history were taken from every patient. All women underwent genetic testing. Ultrasonography and magnetic resonance were diagnostic methods for fetal malformations confirmation. Results: Study included 773 pregnant women aged from 18 to 46 years. Out of registered nine different groups of fetal anomalies/malformations, the most common were malformations of the central nervous system, while majority of fetuses had combined multiple anomalies. Genetic cause for congenital anomalies was present in 25.2% of pregnancies. Medical pregnancy abortion was performed in 71.8% of cases. Only 10.2% of pregnancies ended in term. The best outcome for children was obtained in case of gastrointestinal anomalies (52% live-born). Contrary only one child with neck and thorax malformations could be saved. According to logistic regression the most important predictor of having a child with combined multiple anomalies was mother?s age, while predictor of central nervous system anomalies was gestational diabetes. The significant predictor of genetic anomalies was mother?s age. Conclusion: In our sample neurological congenital anomalies were the most common, although abnormalities of all organ systems were registered. Majority of pregnancies had to be discontinued due to combined multiple anomalies caused by genetic disorders. Older mother?s age and diabetes can imply on the increased risk for fetal malformations.
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Jahan, Kamar, and Binod Kumar Mahaseth. "Intrauterine Foetal Death: A Hospital Based Study." Journal of Nepalgunj Medical College 19, no. 1 (January 16, 2022): 89–91. http://dx.doi.org/10.3126/jngmc.v19i1.40436.

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Introduction: Foetal death at any stage of pregnancy is not just a tragic event but also a more traumatic for the mental well-being of a mother. It is one of the most wrenching events in the field of obstetrics. Aims: The study was done to determine the probable risk factors of intrauterine foetal death and role of antenatal care in its prevention. Methods: The study was conducted in Obstetrics and Gynecology department at Nepalgunj Medical college from July 2018 to July 2020 .Inclusion criteria were intrauterine fetal death of >28 weeks of gestation and baby weighing 1000 grams or more . An exclusion criterion was molar pregnancy. Results: There were 115(3.52%) intrauterine fetal death during the study period, making it 35 per 1000 cases. In 17(14.78%) the cause of intrauterine fetal death was not known. The other common associated risk factors were prematurity in 14(12.17%) and hypertension in 13(11.30%). Similarly anemia and antepartum hemorrhage were seen in 13(11.30%) each. 11(9.56%) patients had oligohydramnios. Mal presentation was found in 8(6.95%) patients while polyhydromnios in 6(5.21%).The commonest age range in whom intrauterine fetal death was seen was 20-30 (73.90%). 28 (24.34%) patients were at preterm pregnancy ranging between 28-30 weeks whereas 17(14.78) intrauterine fetal death occured at 32-34 weeks. 77 foetuses were preterm and their birth weight was between 1 - 1.5 kg with the mean wt of 1175.73 gms. Conclusion: Intrauterine fetal death is still common inspite of the improving awareness in importance of regular antenatal care. In majority, the cause of intrauterine fetal death is still unknown. However, where the cause was known prematurity was the commonest.
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Salim, Thais Rocha, Gabriel Porto Soares, Carlos Henrique Klein, and Gláucia Maria Moraes Oliveira. "Fetal and maternal factors are associated with mortality due to circulatory system disorders in children." Revista de Saúde Pública 53 (March 26, 2019): 31. http://dx.doi.org/10.11606/s1518-8787.2019053000793.

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OBJECTIVE: To analyze the association of characteristics recorded at the time of birth, including weight, occurrence of asphyxia, gestation duration, maternal age and education level, with death from diseases or malformations of the circulatory system in children under 18 years of age. METHODS: The Brazilian Information System on Live Births and Information System on Mortality databases were linked and evaluated following a longitudinal cohort analysis strategy. The following independent variables were evaluated: characteristics recorded at the time of birth, including weight, occurrence of asphyxia, gestation duration, maternal age and education level. Dependent variables were death from diseases or malformations of the circulatory system in children under 18 years of age. Crude relative risks were estimated and relative risks were adjusted for the variables. RESULTS: 6,380 deaths were linked to 4,282,260 birth records, yielding 5,062 pairs considered as true. Low birth weight (RR = 2.26), asphyxia at 1 (RR = 1.72) and 5 minutes (RR = 1.51), prematurity (RR = 1.50), maternal age ≥ 40 years (RR = 2.06), and low maternal education level (RR = 1.45) increased the probability of death caused by circulatory system diseases. In the association with death by malformations of the circulatory system, the predictive variables showed the same association profile, but with greater intensity. CONCLUSIONS: Fetal and maternal factors are associated with increased mortality due to diseases and malformations of the circulatory system. Measures to control these factors and improve access to their diagnosis and treatment would contribute to reducing the number of deaths caused by diseases and malformations of the circulatory system. However, the identification of environmental influences during gestation and birth on the risk of death should be carefully considered due to being influenced by genetic factors.
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Dudenhausen, Joachim W., and Amos Grünebaum. "Epidemiology and Prevention of Fetal Death and Stillbirth." Donald School Journal of Ultrasound in Obstetrics and Gynecology 10, no. 2 (2016): 160–62. http://dx.doi.org/10.5005/jp-journals-10009-1460.

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ABSTRACT In high-income countries, the stillbirth rate did not change during the last decades. For prevention of stillbirth we need an international consens about risk factors, causes and classification of stillbirth, national fetal registries and standadized protocols for stillbirth evaluation. The knowledge from these data may lead to further prevention strategies. How to cite this article Dudenhausen JW, Grünebaum A. Epidemiology and Prevention of Fetal Death and Stillbirth. Donald School J Ultrasound Obstet Gynecol 2016;10(2):160-162.
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HELGADOTTIR, LINDA BJÖRK, FINN EGIL SKJELDESTAD, ANNE FLEM JACOBSEN, PER MORTEN SANDSET, and EVA-MARIE JACOBSEN. "Incidence and risk factors of fetal death in Norway: a case-control study." Acta Obstetricia et Gynecologica Scandinavica 90, no. 4 (March 4, 2011): 390–97. http://dx.doi.org/10.1111/j.1600-0412.2011.01079.x.

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34

Sun, Luming, Gang Zou, Yingjun Yang, Fenhe Zhou, and Duan Tao. "Risk factors for fetal death after radiofrequency ablation for complicated monochorionic twin pregnancies." Prenatal Diagnosis 38, no. 7 (May 9, 2018): 499–503. http://dx.doi.org/10.1002/pd.5269.

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35

Nahar, Kamrun, Selina Akter Banu, Sharmin Siddika, and Atika Begum. "Risk Factors and Fetal Outcome of PE Cases in a Tertiary Level Hospital." Bangladesh Journal of Obstetrics & Gynaecology 34, no. 1 (April 1, 2019): 3–7. http://dx.doi.org/10.3329/bjog.v34i1.56668.

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Objective: To study the risk factors and foetal outcome of pre-eclampsia in a tertiary level hospital. Materials and methods: A total 40 consecutive patients of pre-eclampsia (PE) were included in this study between April 2009 to March 2010. Patients whose B.P. was ³140/90 mm of Hg and proteinuria detected by dipstick test were included in this study. Detailed discussion about the study was done with the patient and then written informed consent was taken from them. Detailed history about patient profile, risk factors and foetal outcome in terms of birth weight, maturity and IUGR(intrauterine growth retardation) etc were recorded in predesigned data collection sheet. Data was expressed in terms of frequenies and percentages. Results: Most of the patients were in the age group of 20-30 years (52.5%) and 60% were primi gravida . Most of the patient (60%) developed pre-eclampsia at 37 weeks of gestation. Regarding risk factors 30% patients were obese, previous history of pre-eclampsia (PE) in 7.5% cases, pregnancy with diabetes was found in 5% cases and multiple pregnancy in 2.5% cases. Caesarean section was done in 72.5% cases and vaginal delivery occurred in 25% cases. Birth weight 2.5-3 kg found in 40% cases. 37.5% babies were premature, IUGR in 7.5%, intrauterine death in 5% and neonatal death was observed in 2% cases. Conclusion: Primi gravida are more prone to develop pre-eclampsia. Obesity, previous history of pre-eclampsia, multiple pregnancy and pregnancy with diabetes mellitus increase the risk of pre-eclampsia. Prematurity, intrauterine growth retardation (IUGR), intrauterine death (IUD), neonatal death are important foetal complications. Bangladesh J Obstet Gynaecol, 2019; Vol. 34(1): 3-7
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Wingate, Martha S., Wanda D. Barfield, Joann Petrini, and Ruben Smith. "Disparities in Fetal Death and First Day Death: The Influence of Risk Factors in 2 Time Periods." American Journal of Public Health 102, no. 8 (August 2012): e68-e73. http://dx.doi.org/10.2105/ajph.2012.300790.

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37

Malik, Adiba, Tahera Begum, and Serajun Noor. "Study on Etiology and Maternal Complications of Intrauterine Fetal Death." Chattagram Maa-O-Shishu Hospital Medical College Journal 18, no. 1 (July 10, 2019): 23–26. http://dx.doi.org/10.3329/cmoshmcj.v18i1.42133.

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Background : Management of pregnancy with good fetal and maternal outcome is a challenge to the obstetrician which can be achieved by screening the risk factors of Intra Uterine Fetal Death (IUFD) and thereby prevent, control and treat them by quality preconceptional and antenatal care. Materials and methods: This cross-sectional study, done in a tertiary care hospital during a period of two years where 100 pregnant women with history of intrauterine fetal death were included after informed written consent. Intrauterine fetal death was confirmed by Ultrasonogram. Different risk factors and maternal complications were observed. Then data was analyzed with the help of SPSS-20. Results: Among 100 women, maximum patients were aggregated between age group 26-35 years (45%) and next to which was 16-25 years (35%) primipara was 32% and multipara was 31%. Regarding Antenatal care (ANC) 32% patients attended two antenatal visits and 28 % patients had no antenatal visits and 18% patients completed > 5 visits. Regarding causes of IUFD, 34% due to hypertension in pregnancy, 14% mother was severely anemic, 13% mother had Diabetes Mellitus (DM) abruptio placenta was found in 15% mother, maternal gastroenteritis 05%, maternal fever 09%, cord accident 3% and in 19% cases no causes were identified. Regarding maternal complications, blood transfusion needed in 28% patients, PPH occurred in 12% patients, Sepsis 08%, caesarean section needed in 07 % cases, ARF 4%, DIC in 03% cases and maternal mortality 01%. Mean ± SD of total hospital stay was 4 ± 1.5 days. Conclusion: There are different risk factors of IUFD which if identified earlier,then by treating the correctable etiologies, recurrence of IUFD and its related maternal complications can be prevented or reduced. Chatt Maa Shi Hosp Med Coll J; Vol.18 (1); Jan 2019; Page 23-26
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Kuikel, Sandip, Prezma Shrestha, Sunita Bajracharya, Sagar Poudel, and Bijaya Thapa. "Factors Related to Late Intrauterine Fetal Death in a Tertiary Referral Center: A Retrospective Study." Europasian Journal of Medical Sciences 3, no. 1 (February 10, 2021): 34–39. http://dx.doi.org/10.46405/ejms.v3i1.286.

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Backgroun: Intrauterine fetal death (IUFD) is a contributor of perinatal outcome and is an important indicator of the quality of antenatal care. Despite efforts, risk factors cannot be identified in cases of intrauterine fetal deaths. This study aims to identify the maternal, fetal, placental and cord related factors related to it. Methods: It is a retrospective cross-sectional study conducted analyzing patients admitted with IUFDs after 28 weeks of pregnancy at Tribhuwan University Teaching Hospital from April 2019 to March 2020. It was conducted after taking ethical approval from Institutional Review Committee (IRC) of Institute of Medicine. Data were collected from review of charts of individual patients in MS Excel and was analyzed using SPSS. Results: There were 5496 births and 46 intrauterine fetal deaths during the study period giving stillbirth rate of 8 per 1000 births. It was common in the age group of 26-30 years (34.8%), 62.2% were from inside Kathmandu valley,43.5% were just literate, 13% were illiterate, 84.8% were housewives, 56.5% were primigravida and 69.57% of the babies were preterm. Only four percent had previous history of intra uterine fetal deaths. Hypertensive disorders complicating pregnancy were found in 30.5% followed by heart disease in 10.9% of the mothers. There were no known co-morbidities in 26.1% of the patients. Out of total 46 cases, 62% were female. Two had Rh isoimmunization and four had congenital malformations. Placenta previa was seen in four percent and abruptio placenta in two percent. Twin pregnancy with diamniotic dichorionic placenta was present in four percent. Seventeen percent of the babies had cord around the neck and two percent had thrombosis of the umbilical cord. Conclusion: Low level of maternal education and maternal comorbidities like hypertensive disorders complicating pregnancy were found to be most common factors seen in cases of intrauterine fetal deaths.
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Costa, Mayanna Karlla Lima, Vilena Aparecida Ribeiro Silva, and Raimunda Alves Silva. "FETAL DEATHS IN MARANHÃO STATE (BRAZIL), IN THE YEARS OF 2000, 2010 AND 2014." Journal of Geospatial Modelling 2, no. 3 (December 9, 2017): 33. http://dx.doi.org/10.22615/2526-1746-jgm-2.3-6864.

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The occurrence of a high number of fetal deaths is present throughout the world. It is estimated that more than 2 million fetal deaths occur each year on the globe, where 98% predominate in developing countries. This research aimed to carry out the survey of the fetal deaths number in Maranhão state, as a way to bring contributions to theprevention and health care actions. Data from DATASUS were used for the survey of fetal deaths occurring in the 217 municipalities in Maranhão state in the years 2000, 2010 and 2014, as well as the fetal mortality rate. The program SURFER® version 11.0 were usedfor descriptive statistics analysis and construction of the mean distribution map of cases. The fetal mortality rate in Maranhão has increased over the years, not following the national trend of reduction of intrauterine mortality rates, being required greater investment in public policies to analyze the main risk factors in the state.Key words: fetal death, public health, fetal mortality rate.
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Bezhenar, Vitaliy F., Lidia A. Ivanova, Elena V. Frederiks, and Raisa I. Anashkina. "Somatic features and reproduction characteristics of patients with perinatal fetal death." Journal of obstetrics and women's diseases 68, no. 2 (May 29, 2019): 33–42. http://dx.doi.org/10.17816/jowd68233-42.

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Aims of study. The current analysis was undertaken to determine risk factors for perinatal losses and assess the possibility of their prediction. Study design, materials and methods. We analyzed 307 cases of perinatal death in obstetric facilities of the Leningrad region (main group). 357 women who gave birth to living children who lived 7 days of the perinatal period represented the control comparison group. A retrospective analysis was carried out based on medical hospital records: an examination of events during pregnancy, childbirth, postpartum, and early infancy, as well as afterbirth study findings and autopsy reports. Results. We performed a retrospective analysis of the social (3 factors), somatic (28 factors), and reproductive (15 factors) statuses of patients with perinatal losses in order to try to assess the possibility of identifying risk groups and predicting perinatal and fetal mortality. Conclusion. The predictors of perinatal mortality were determined, namely features of social status (absence of a marriage record and a permanent job, low level of education), somatic status (diabetes, cardiovascular pathology, arterial hypertension, chronic hemocontact infections), and reproductive status (late menarche, early sexual debut, previous infectious genital pathology, childbirth at a young age, etc.).
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Dhahir, Asmar, and Shahla Alalaf. "Maternal and neonatal characteristics that influence early neonatal deaths in a maternity teaching hospital." Zanco Journal of Medical Sciences 26, no. 2 (August 14, 2022): 96–107. http://dx.doi.org/10.15218/zjms.2022.011.

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Background and objective: Low early neonatal death reflects health care progress in any country. We aimed to determine the prevalence of early neonatal deaths and the associated maternal and neonatal factors in a hospital-based study. Methods: This audit study was conducted on all newborns in the labor ward and neonatal intensive care unit of a maternity teaching hospital in Erbil city, Kurdistan Region, Iraq, from January 1, 2020, to December 31, 2020. Fetal and maternal factors were determined and correlated with early neonatal deaths. Results: The early neonatal death rate was 6.7%. All categories of preterm deliveries (extreme, very, and moderate preterm) were significantly associated with early neonatal deaths (odds ratios [ORs] = 45.1, 6.2, and 2.1, respectively). The primiparous and grand multiparous women had a higher risk of early neonatal deaths (ORs = 8.4 and 13.0, respectively). Obese women had a higher risk of early neonatal deaths (OR = 3.3). The risk of early neonatal deaths was significantly high when the number of antenatal care visits was less than four (OR = 8.1). Delivery by cesarean section was associated with high risk (OR = 3.8). Regarding the Apgar scores in the first and fifth minutes after birth, early neonatal death was significantly higher among those with severely depressed scores. Conclusion: High parity, inadequate antenatal attendance, obesity, and mode of delivery, were contributing factors to early neonatal deaths. Early prenatal care can assist in the rapid identification and management of risk factors for early neonatal deaths. Keywords: Early neonatal death; Parity; Low birth weight; Maternal characteristics; Overweight.
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Bohiltea, Roxana, Natalia Turcan, Christina Cavinder, Ionită Ducu, Ioana Paunica, Liliana Andronache, and Monica Cirstoiu. "Risk factors, predictive markers and prevention strategies for intrauterine fetal death. An integrative review." Journal of Mind and Medical Sciences 7, no. 1 (April 4, 2020): 52–60. http://dx.doi.org/10.22543/7674.71.p5260.

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43

Bala, Dr K. R. Lohita, Dr Manali Sewalkar, Dr Sehal Shah, and Dr Meka Keerthana. "Meconium Stained Amniotic Fluid and its Relation to Maternal Risk Factors." Scholars Journal of Applied Medical Sciences 9, no. 12 (December 26, 2021): 1891–95. http://dx.doi.org/10.36347/sjams.2021.v09i12.020.

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Background: Meconium stained amniotic fluid has been considered a sign of fetal distress in presentations other than breech and associated with poor fetal outcome but others considered meconium passage by fetus as physiological phenomenon and produces environmental hazards to fetus before birth. Such magnitude of different opinion was the object behind taking up of this study. Aims and objectives: To study maternal risk factors responsible for meconium stained amniotic fluid and its correlation with the fetal outcome in terms of morbidity and mortality. Meterial and methods: 100 women in labour with meconium stained amniotic fluid studied considering the inclusion criteria in the Department of Obstetrics and Gynecology, Pravara Rural Hospital, Loni. Cases divided into two -‘thin’ and ‘thick’ meconium stained group. Maternal and Fetal monitoring, uterine contraction assessed and Apgar score, birth weight, resuscitation of baby noted. All babies of both group followed up to first week neonatal life. Results: In our study, among 100 cases, 45% of the cases had thin meconium and 55% had thick meconium. Increased incidence of meconium staining was seen in crossed dates. The other risk factors were hypertension, anemia, oligohydramnios, IUGR. 56% went in for cesarean section due to intrapartum fetal distress. 33% of the cases went into NICU in view of low APGAR score due to birth asphyxia and meconium aspiration syndrome. Perinatal death was seen in 4 cases, one due to birth asphyxia and the other three due to MAS. Conclusion: Based on this study we conclude that meconium stained amniotic fluid is associated with increased incidence of caesarean section, low APGAR score, meconium aspiration syndrome and increased NICU admission.
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Stabile, Guglielmo, Stefania Carlucci, Lucia De Bonis, Felice Sorrentino, Luigi Nappi, and Giuseppe Ricci. "Umbilical Cord Knots: Is the Number Related to Fetal Risk?" Medicina 58, no. 6 (May 25, 2022): 703. http://dx.doi.org/10.3390/medicina58060703.

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True knots of the umbilical cord (UC) are a rare occurrence and are reported in 0.4–1.2% of deliveries. The compression of true knot of the UC can cause obstruction of the fetal circulation, leading to intra-uterine growth retardation or fetal death. Predisposing factors for the genesis of the true UC knot are numerous and include all the conditions, which lead to a relatively large uterine volume. This situation may predispose to free and excessive fetal movements. Although not all true knots lead to perinatal complications, they have been associated with adverse pregnancy outcomes, including fetal distress, fetal hypoxia, intra-uterine growth restriction (IUGR), long-term neurological damage, caesarean delivery and stillbirth. We present a rare case of operative delivery with vacuum in a multiparous woman at term of pregnancy with a double true knot of the UC. As in most cases, the diagnosis was made after delivery, as there were no fetal symptoms during pregnancy. Some authors assume that 3D power sonography may be useful in the diagnosis of true UC knots. However, 3D power Doppler cannot be considered as a definitive method. There are no specific prenatal indications to induce the physician to look for ultrasound signs suggestive of umbilical true knot. Some studies argue that cases of fetal death and fetal risk are directly related to the number of knots. We also support this thesis, even if further observational and retrospective studies are needed to demonstrate it.
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Di Mascio, Daniele, Cihat Sen, Gabriele Saccone, Alberto Galindo, Amos Grünebaum, Jun Yoshimatsu, Milan Stanojevic, et al. "Risk factors associated with adverse fetal outcomes in pregnancies affected by Coronavirus disease 2019 (COVID-19): a secondary analysis of the WAPM study on COVID-19." Journal of Perinatal Medicine 48, no. 9 (November 26, 2020): 950–58. http://dx.doi.org/10.1515/jpm-2020-0355.

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AbstractObjectivesTo evaluate the strength of association between maternal and pregnancy characteristics and the risk of adverse perinatal outcomes in pregnancies with laboratory confirmed COVID-19.MethodsSecondary analysis of a multinational, cohort study on all consecutive pregnant women with laboratory-confirmed COVID-19 from February 1, 2020 to April 30, 2020 from 73 centers from 22 different countries. A confirmed case of COVID-19 was defined as a positive result on real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay of nasal and pharyngeal swab specimens. The primary outcome was a composite adverse fetal outcome, defined as the presence of either abortion (pregnancy loss before 22 weeks of gestations), stillbirth (intrauterine fetal death after 22 weeks of gestation), neonatal death (death of a live-born infant within the first 28 days of life), and perinatal death (either stillbirth or neonatal death). Logistic regression analysis was performed to evaluate parameters independently associated with the primary outcome. Logistic regression was reported as odds ratio (OR) with 95% confidence interval (CI).ResultsMean gestational age at diagnosis was 30.6±9.5 weeks, with 8.0% of women being diagnosed in the first, 22.2% in the second and 69.8% in the third trimester of pregnancy. There were six miscarriage (2.3%), six intrauterine device (IUD) (2.3) and 5 (2.0%) neonatal deaths, with an overall rate of perinatal death of 4.2% (11/265), thus resulting into 17 cases experiencing and 226 not experiencing composite adverse fetal outcome. Neither stillbirths nor neonatal deaths had congenital anomalies found at antenatal or postnatal evaluation. Furthermore, none of the cases experiencing IUD had signs of impending demise at arterial or venous Doppler. Neonatal deaths were all considered as prematurity-related adverse events. Of the 250 live-born neonates, one (0.4%) was found positive at RT-PCR pharyngeal swabs performed after delivery. The mother was tested positive during the third trimester of pregnancy. The newborn was asymptomatic and had negative RT-PCR test after 14 days of life. At logistic regression analysis, gestational age at diagnosis (OR: 0.85, 95% CI 0.8–0.9 per week increase; p<0.001), birthweight (OR: 1.17, 95% CI 1.09–1.12.7 per 100 g decrease; p=0.012) and maternal ventilatory support, including either need for oxygen or CPAP (OR: 4.12, 95% CI 2.3–7.9; p=0.001) were independently associated with composite adverse fetal outcome.ConclusionsEarly gestational age at infection, maternal ventilatory supports and low birthweight are the main determinants of adverse perinatal outcomes in fetuses with maternal COVID-19 infection. Conversely, the risk of vertical transmission seems negligible.
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Pacora, Percy, Roberto Romero, Sunil Jaiman, Offer Erez, Gaurav Bhatti, Bogdan Panaitescu, Neta Benshalom-Tirosh, et al. "Mechanisms of death in structurally normal stillbirths." Journal of Perinatal Medicine 47, no. 2 (February 25, 2019): 222–40. http://dx.doi.org/10.1515/jpm-2018-0216.

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Abstract Objectives To investigate mechanisms of in utero death in normally formed fetuses by measuring amniotic fluid (AF) biomarkers for hypoxia (erythropoietin [EPO]), myocardial damage (cardiac troponin I [cTnI]) and brain injury (glial fibrillary acidic protein [GFAP]), correlated with risk factors for fetal death and placental histopathology. Methods This retrospective, observational cohort study included intrauterine deaths with transabdominal amniocentesis prior to induction of labor. Women with a normal pregnancy and an indicated amniocentesis at term were randomly selected as controls. AF was assayed for EPO, cTnI and GFAP using commercial immunoassays. Placental histopathology was reviewed, and CD15-immunohistochemistry was used. Analyte concentrations >90th centile for controls were considered “raised”. Raised AF EPO, AF cTnI and AF GFAP concentrations were considered evidence of hypoxia, myocardial and brain injury, respectively. Results There were 60 cases and 60 controls. Hypoxia was present in 88% (53/60), myocardial damage in 70% (42/60) and brain injury in 45% (27/60) of fetal deaths. Hypoxic fetuses had evidence of myocardial injury, brain injury or both in 77% (41/53), 49% (26/53) and 13% (7/53) of cases, respectively. Histopathological evidence for placental dysfunction was found in 74% (43/58) of these cases. Conclusion Hypoxia, secondary to placental dysfunction, was found to be the mechanism of death in the majority of fetal deaths among structurally normal fetuses. Ninety-one percent of hypoxic fetal deaths sustained brain, myocardial or both brain and myocardial injuries in utero. Hypoxic myocardial injury was an attributable mechanism of death in 70% of the cases. Non-hypoxic cases may be caused by cardiac arrhythmia secondary to a cardiac conduction defect.
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47

Bonasoni, Maria Paola, Barbara Muciaccia, Caterina B. Pelligra, Matteo Goldoni, and Rossana Cecchi. "Third trimester intrauterine fetal death: proposal for the assessment of the chronology of umbilical cord and placental thrombosis." International Journal of Legal Medicine 136, no. 3 (February 11, 2022): 705–11. http://dx.doi.org/10.1007/s00414-022-02784-3.

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AbstractThe timing of umbilical cord and placental thrombosis in the third trimester intrauterine fetal death (TT-IUFD) may be fundamental for medico-legal purposes, when it undergoes medical litigation due to the absence of risk factors. Authors apply to human TT-IUFD cases a protocol, which includes histochemistry and immunohistochemistry (IHC) for the assessment of thrombi’s chronology. A total of 35 thrombi of umbilical cord and/or placenta were assessed: 2 in umbilical artery, 6 in umbilical vein, 15 in insertion, 10 in chorionic vessels, 1 in fetal renal vein, 1 in fetal brachiocephalic vein. Thrombi’s features were evaluated with hematoxylin–eosin, Picro-Mallory, Von Kossa, Perls, and immunohistochemistry for CD15, CD68, CD31, CD61, and Smooth Muscle Actin. The estimation of the age of the thrombi was established by applying neutrophils/macrophages ratio taking into consideration, according to literature, the presence of hemosiderophagi, calcium deposition, and angiogenesis. To estimate an approximate age of fresh thrombi (< 1 day), a non-linear regression model was tested. Results were compared to maternal risk factors, fetal time of death estimated at autopsy, mechanism, and cause of death. Our study confirms that the maternal risk factors for fetal intrauterine death and the pathologies of the cord, followed by those of the placental parenchyma, are the conditions that are most frequently associated with the presence of thrombi. Results obtained with histological stainings document that the neutrophile/macrophage ratio is a useful tool for determining placental thrombi’s age. Age estimation of thrombi on the first day is very challenging; therefore, the study presented suggests the N/M ratio as a parameter to be used, together with others, i.e., hemosiderophagi, calcium deposition, and angiogenesis, for thrombi’s age determination, and hypothesizes that its usefulness regards particularly the first days when all other parameters are negative.
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48

Al Hosani, H. A., J. Brebner, A. B. Bener, and J. N. Norman. "Study of mortality risk factors for children under age 5 in Abu Dhabi." Eastern Mediterranean Health Journal 9, no. 3 (September 1, 2021): 333–43. http://dx.doi.org/10.26719/2003.9.3.333.

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We investigated the association of biological, sociocultural and economic risk factors with child mortality in Abu Dhabi from 1 January-31 December 1997. With McNemar chi-squared test, most selected biological risk factors were statistically associated with child mortality, although maternal age older than 40 years and history of fetal death were not positively correlated with neonate, infant or age under 5 mortality. Among sociocultural and economic risk factors, maternal lack of formal education and low monthly income were significantly associated with child death. Consanguinity was significantly associated with under 5 and infant but not neonatal mortality. Gestation <37 weeks was highly associated with mortality among all ages. Strengthening health care programmes and emphasizing the need to identify high risk groups should be priorities
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Ara, Shabnam, Shazia Nisar, and Umrazia Bashir. "Incidence and risk factors of intra uterine fetal death: a retrospective study at a tertiary care centre in Kashmir, India." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 4 (March 26, 2019): 1517. http://dx.doi.org/10.18203/2320-1770.ijrcog20191210.

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Background: Intrauterine fetal death (IUFD) is the tragic event contributing to high perinatal mortality in developing countries. So many risk factors have been seen associated with IUFD that can be prevented with better antenatal care and timely detection at the earliest so that the prevalence can be decreased. This study was done to identify the risk factors associated with IUFD.Methods: This is a retrospective study from done from March 2017 to March 2018 at skims maternity hospital. IUFD was defined as fetal death beyond 20 weeks of gestation. Records were analyzed and data was compiled.Results: In our study there were total of 2500 deliveries out of which 70 were IUFD. Incidence was 28 per 1000 live births. It was found more common in the age group of 20-29 year (65.71%) %). Preeclampsia was the risk factor in 17.14% of cases , followed by abruption in 11.42% followed by placenta previa in 7.14% of cases. However, 20% of the cases had unidentified risk factor.Conclusions: Present study was an effort to compile common risk factors associated with IUFD at tertiary centre of Kashmir.
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OLADAPO, Olufemi T., Daniel A. ADEKANLE, and Bankole O. DUROJAIYE. "Maternal risk factors associated with fetal death during antenatal care in low-resource tertiary hospitals." Australian and New Zealand Journal of Obstetrics and Gynaecology 47, no. 5 (September 14, 2007): 383–88. http://dx.doi.org/10.1111/j.1479-828x.2007.00761.x.

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