Research Article
BibTex RIS Cite

INTRAUTERİN FETUS ÖLÜMÜ: ETYOLOJİSİ VE ÖNLENMESİ

Year 2006, Issue: 012, 127 - 132, 15.12.2006

Abstract

Intrauterin fetus ölümü (IUFÖ) Dünya Sağlık Örgütünün tanımına göre 20. gebelik haftasından sonraki ve ya gestasyonel hafta bilinmiyorsa normal gelişen bir fetusda 500 gr. üstünde doğum ağırlığına sahip fetusun intrauterin kaybıdır. 500 gr üstü fetus da yaklaşık olarak 22. gebelik haftasına tekabül eder (2). IUFÖ çok sık görülmemekle birlikte ani yenidoğan ölümü sıklığından 10 kat daha fazladır (1). 2002 yılında Amerika Birleşik Devletleri’nde, 26,000 IUFÖ kaydedilmiş olup bu ‘6.4/1,000 toplam doğum sayısı’ oranına karşılık gelmektedir. Aynı yıl 28,000 infant ölümü (7.0/1,000 canlı doğum) ve 19,000 yenidoğan ölümü (4.7/1000 canlı doğum) meydana gelmiştir (3). 1950’lerden sonra IUFÖ hızında azalma olmuştur, fakat bu azalma yenidoğan ölüm hızındaki azalmadan daha azdır. Geniş serilerde IUFÖ gebelik haftasına göre ikiye ayrılmıştır, 20-28 gebelik haftası arası erken fetal kayıplar, 29. gebelik haftası ve sonrası geç fetal kayıplar olarak sınıflandırılmıştır (3). Bu sınıflandırma etyolojide önemlidir, erken gebelik haftalarında meydana gelen kayıplarda büyük çoğunluğu enfeksiyonlar oluştururken herhangi bir neden bulunamazsa ‘açıklanamayan’ olarak sınıflandırılır (4).

References

  • [1] Infant mortality. Statistics from the 1999 period linked birth/ death data set.Available at:www.cdc.gov/nchs/data/nsvr/nsvr50/nsvr50_04.pdf. Accessed on October 10, 2002.
  • [2] World Health Organization. The OBSQUID Project: quality development in perinatal care, final report. Publ Eur Serv 1995.
  • [3] Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Munson ML. Births: final data for 2002. natl Vital Stat Rep 2003; 52: 1-113.
  • [4] Fretts RC, Boyd ME, Usher RH, Usher HA. The changing pattern of fetal death, 1961-1988. Obstet Gynecol 1992; 79: 35-9.
  • [5] Yudkin PL, Wood L, Redman CW. Risk of unexplained stillbirth at different gestational ages. Lancet 1987, 1: 1192-4.
  • [6] Huang DY, Usher RH, Kramer MS, Yang H, Morin L, Fretts RC. Determinants of unexplained antepartum fetal deaths. Obstet Gynecol 2000; 95: 215-21.
  • [7] Froen JF, Arnestad M, Frey K, Vege A, Saugstad OD, Stray-Pedersen B. Risk factors for sudden intrauterine unexplained death: epidemiologic characteristics of singleton cases in Oslo, Norway, 1986-1995. Am J Obstet Gynecol 2001; 184: 694- 702.
  • [8] Alessandri LM, Stanley FJ, Newnham J, Walters BN. The epidemilogical charasteristics of unexplained antepartum stillbirths. Early Hum Dev 1992; 30: 147-61.
  • [9] Shankar M, Navti O, Amu O, Konje JC. Assessment of stillbirth risk and associated risk factors in atertiary hospital. J Obstet Gyneacol 2002; 22 : 34-8.
  • [10] Orskou J, Henriksen TB, Kesmodel U, Secher NJ. Maternal characteristics and lifestyle factors and the risk of delivering high birth weight infants. Obstet Gynecol 2003; 102: 115-20.
  • [11] Cnattingius S, Bergstrom R, Lipworth L, Kramer MS. Prepregnancy weight and the risk of adverse pregnancy outcomes. N Engl J Med 1998; 338: 147-52.
  • [12] Cedergren MI. Maternal morbid obesity and the risk of adverse pregnancy outcome. Obstet Gynecol 2004; 103, 219-24.
  • [13] Naeye RL. Maternal body weight and pregnancy outcome. Am J Obstet Clin Nutr 1990; 52: 273-9.
  • [14] Stephansson O, Dickman PW, Johansson A, Cnattingius S. Maternal weight, pregnancy weight gain, and the risk of antepartum stillbirth. Am J Obstet Gynecol 2001; 184: 463-9.
  • [15] Stone JL, Lockwood CJ, Berkowitz GS, Alvarez M, Lapinski R, Berkowitz RL. Risk factors for severe preeclampsia. Obstet Gynecol 1994; 83: 357-61.
  • [16] Maasilta P, Bachour A, Teramo K, Polo O, Laitinen LA. Sleep related disordered breathing during pregnancy in obese women. Chest 2001; 120: 1448-54.
  • [17] Simpson LL. Maternal medical disease: risk of antepartum fetal death. Semin Perinatol 2002; 26: 42-50.
  • [18] Georgiou PE, Politi EN, Katsimbri P, Sakka V, Drosos AA. Outcome of lupus pregnancy: a controlled study. Rheumatology (Oxford) 2000; 39: 1014-9.
  • [19] Le Huong D, Wechsler B, Vauthier-Brouzes D, Seebacher J, Lefebvre G, Bletry O, et al. Outcome of planned pregnancies in systemic lupus erithematosus: a prospective study on 62 pregnancies. Br J Rheumatol 1997; 36: 772-7.
  • [20] Rahman FZ, Rahman J, Al-Suleiman SA, Rahman MS. Pregnancy outcome in lupus nephropathy. Obstet Gynecol Surv 2004; 59: 754-5.
  • [21] Brenner B, Hoffman R, Blumenfeld Z, Weiner Z, Younis JS,Gestational outcome in trombophilic women with recurrent pregnancy loss treated by enoxaparin. Thromb Haemost 2000; 83: 693-7.
  • [22] Gibbs RS. The origins of stillbirth: infectious diseases. Semin Perinatol 2002; 26: 75-8.
  • [23] Refuerzo J, Chaiwirapongsa T, Gervasi MT, Kim JC,Yoon BH, Romero R. Idiopathic fetal death is associated with evidence of prior antigenic exposure. Obstet Gynecol 2002;99:18s.
  • [24] Blackwell S, Romero R, Chaiworapongsa T, Refuerzo J, Gervasi MT, Yoshimatsu J, et al. Unexplained fetal death is associated with changes in the adaptive limb of the maternal immune response consistent with prior antigenic exposure. J Matern Fetal Neonatal Med 2003; 14: 241-6.
  • [25] Froen JF, Moyland RA, Saugstad OD, Stray-Pedersen B. Maternal health in sudden intrauterine unexplained death: do urinary tract infections protect the fetus? Obstet Gynecol 2002; 100: 909-15.
  • [26] Smith GC, Stenhouse EJ, Crossley JA, Aitken DA, Cameron AD, Connor JM. Early pregnancy levels of pregnancy-associated plasma protein A and the risk of intrauterine growth restriction, premature birth, preeclampsia, and stillbirth. J Clin Endocrinol Metab 2002; 87: 1762-7.
  • [27] Zhang J, Klebanoff MA. Small for gestational age infants and risk of fetal death in subsequent pregnancies. N Engl J Med 2004; 350: 754-6.
  • [28] Frias AE Jr, Luikenaar RA, Sullivan AE, Lee RM, Porter TF, Branch DW, et al. Poor obstetric outcome in subsequent pregnancies in women with prior fetal death. Obstet Gynecol 2004; 104: 521-6.
  • [29] Smith GC, Pell JP, Dobbie R. Caesarean section and risk of unexplained stillbirth in subsequent pregnancy. Lancet 2003; 362: 1779-84.
  • [30] Fretts RC, Elkin EB, Myers ER, Heffner LJ. Should older women have antepartum testing to prevent unexplained stillbirth? Obstet Gynecol 2004; 104: 56-64.
  • [31] Tolfvenstam T, Papadogiannakis N, Norbeck O, Petersson K, Broliden K, Nyman M. Parvovirus B19 infection in intrauterine fetal death. Lancet 2001; 357: 1494-7.

INTRAUTERİN FETUS ÖLÜMÜ: ETYOLOJİSİ VE ÖNLENMESİ

Year 2006, Issue: 012, 127 - 132, 15.12.2006

Abstract

Intrauterin fetus ölümü (IUFÖ) Dünya Sağlık Örgütünün tanımına göre 20. gebelik haftasından sonraki ve ya gestasyonel hafta bilinmiyorsa normal gelişen bir fetusda 500 gr. üstünde doğum ağırlığına sahip fetusun intrauterin kaybıdır. 500 gr üstü fetus da yaklaşık olarak 22. gebelik haftasına tekabül eder (2). IUFÖ çok sık görülmemekle birlikte ani yenidoğan ölümü sıklığından 10 kat daha fazladır (1). 2002 yılında Amerika Birleşik Devletleri’nde, 26,000 IUFÖ kaydedilmiş olup bu ‘6.4/1,000 toplam doğum sayısı’ oranına karşılık gelmektedir. Aynı yıl 28,000 infant ölümü (7.0/1,000 canlı doğum) ve 19,000 yenidoğan ölümü (4.7/1000 canlı doğum) meydana gelmiştir (3). 1950’lerden sonra IUFÖ hızında azalma olmuştur, fakat bu azalma yenidoğan ölüm hızındaki azalmadan daha azdır. Geniş serilerde IUFÖ gebelik haftasına göre ikiye ayrılmıştır, 20-28 gebelik haftası arası erken fetal kayıplar, 29. gebelik haftası ve sonrası geç fetal kayıplar olarak sınıflandırılmıştır (3). Bu sınıflandırma etyolojide önemlidir, erken gebelik haftalarında meydana gelen kayıplarda büyük çoğunluğu enfeksiyonlar oluştururken herhangi bir neden bulunamazsa ‘açıklanamayan’ olarak sınıflandırılır (4).

References

  • [1] Infant mortality. Statistics from the 1999 period linked birth/ death data set.Available at:www.cdc.gov/nchs/data/nsvr/nsvr50/nsvr50_04.pdf. Accessed on October 10, 2002.
  • [2] World Health Organization. The OBSQUID Project: quality development in perinatal care, final report. Publ Eur Serv 1995.
  • [3] Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Munson ML. Births: final data for 2002. natl Vital Stat Rep 2003; 52: 1-113.
  • [4] Fretts RC, Boyd ME, Usher RH, Usher HA. The changing pattern of fetal death, 1961-1988. Obstet Gynecol 1992; 79: 35-9.
  • [5] Yudkin PL, Wood L, Redman CW. Risk of unexplained stillbirth at different gestational ages. Lancet 1987, 1: 1192-4.
  • [6] Huang DY, Usher RH, Kramer MS, Yang H, Morin L, Fretts RC. Determinants of unexplained antepartum fetal deaths. Obstet Gynecol 2000; 95: 215-21.
  • [7] Froen JF, Arnestad M, Frey K, Vege A, Saugstad OD, Stray-Pedersen B. Risk factors for sudden intrauterine unexplained death: epidemiologic characteristics of singleton cases in Oslo, Norway, 1986-1995. Am J Obstet Gynecol 2001; 184: 694- 702.
  • [8] Alessandri LM, Stanley FJ, Newnham J, Walters BN. The epidemilogical charasteristics of unexplained antepartum stillbirths. Early Hum Dev 1992; 30: 147-61.
  • [9] Shankar M, Navti O, Amu O, Konje JC. Assessment of stillbirth risk and associated risk factors in atertiary hospital. J Obstet Gyneacol 2002; 22 : 34-8.
  • [10] Orskou J, Henriksen TB, Kesmodel U, Secher NJ. Maternal characteristics and lifestyle factors and the risk of delivering high birth weight infants. Obstet Gynecol 2003; 102: 115-20.
  • [11] Cnattingius S, Bergstrom R, Lipworth L, Kramer MS. Prepregnancy weight and the risk of adverse pregnancy outcomes. N Engl J Med 1998; 338: 147-52.
  • [12] Cedergren MI. Maternal morbid obesity and the risk of adverse pregnancy outcome. Obstet Gynecol 2004; 103, 219-24.
  • [13] Naeye RL. Maternal body weight and pregnancy outcome. Am J Obstet Clin Nutr 1990; 52: 273-9.
  • [14] Stephansson O, Dickman PW, Johansson A, Cnattingius S. Maternal weight, pregnancy weight gain, and the risk of antepartum stillbirth. Am J Obstet Gynecol 2001; 184: 463-9.
  • [15] Stone JL, Lockwood CJ, Berkowitz GS, Alvarez M, Lapinski R, Berkowitz RL. Risk factors for severe preeclampsia. Obstet Gynecol 1994; 83: 357-61.
  • [16] Maasilta P, Bachour A, Teramo K, Polo O, Laitinen LA. Sleep related disordered breathing during pregnancy in obese women. Chest 2001; 120: 1448-54.
  • [17] Simpson LL. Maternal medical disease: risk of antepartum fetal death. Semin Perinatol 2002; 26: 42-50.
  • [18] Georgiou PE, Politi EN, Katsimbri P, Sakka V, Drosos AA. Outcome of lupus pregnancy: a controlled study. Rheumatology (Oxford) 2000; 39: 1014-9.
  • [19] Le Huong D, Wechsler B, Vauthier-Brouzes D, Seebacher J, Lefebvre G, Bletry O, et al. Outcome of planned pregnancies in systemic lupus erithematosus: a prospective study on 62 pregnancies. Br J Rheumatol 1997; 36: 772-7.
  • [20] Rahman FZ, Rahman J, Al-Suleiman SA, Rahman MS. Pregnancy outcome in lupus nephropathy. Obstet Gynecol Surv 2004; 59: 754-5.
  • [21] Brenner B, Hoffman R, Blumenfeld Z, Weiner Z, Younis JS,Gestational outcome in trombophilic women with recurrent pregnancy loss treated by enoxaparin. Thromb Haemost 2000; 83: 693-7.
  • [22] Gibbs RS. The origins of stillbirth: infectious diseases. Semin Perinatol 2002; 26: 75-8.
  • [23] Refuerzo J, Chaiwirapongsa T, Gervasi MT, Kim JC,Yoon BH, Romero R. Idiopathic fetal death is associated with evidence of prior antigenic exposure. Obstet Gynecol 2002;99:18s.
  • [24] Blackwell S, Romero R, Chaiworapongsa T, Refuerzo J, Gervasi MT, Yoshimatsu J, et al. Unexplained fetal death is associated with changes in the adaptive limb of the maternal immune response consistent with prior antigenic exposure. J Matern Fetal Neonatal Med 2003; 14: 241-6.
  • [25] Froen JF, Moyland RA, Saugstad OD, Stray-Pedersen B. Maternal health in sudden intrauterine unexplained death: do urinary tract infections protect the fetus? Obstet Gynecol 2002; 100: 909-15.
  • [26] Smith GC, Stenhouse EJ, Crossley JA, Aitken DA, Cameron AD, Connor JM. Early pregnancy levels of pregnancy-associated plasma protein A and the risk of intrauterine growth restriction, premature birth, preeclampsia, and stillbirth. J Clin Endocrinol Metab 2002; 87: 1762-7.
  • [27] Zhang J, Klebanoff MA. Small for gestational age infants and risk of fetal death in subsequent pregnancies. N Engl J Med 2004; 350: 754-6.
  • [28] Frias AE Jr, Luikenaar RA, Sullivan AE, Lee RM, Porter TF, Branch DW, et al. Poor obstetric outcome in subsequent pregnancies in women with prior fetal death. Obstet Gynecol 2004; 104: 521-6.
  • [29] Smith GC, Pell JP, Dobbie R. Caesarean section and risk of unexplained stillbirth in subsequent pregnancy. Lancet 2003; 362: 1779-84.
  • [30] Fretts RC, Elkin EB, Myers ER, Heffner LJ. Should older women have antepartum testing to prevent unexplained stillbirth? Obstet Gynecol 2004; 104: 56-64.
  • [31] Tolfvenstam T, Papadogiannakis N, Norbeck O, Petersson K, Broliden K, Nyman M. Parvovirus B19 infection in intrauterine fetal death. Lancet 2001; 357: 1494-7.
There are 31 citations in total.

Details

Primary Language English
Subjects Engineering
Journal Section Articles
Authors

Emine Çoşar

Erdoğan Soyuçen This is me

Publication Date December 15, 2006
Published in Issue Year 2006 Issue: 012

Cite

APA Çoşar, E., & Soyuçen, E. (2006). INTRAUTERİN FETUS ÖLÜMÜ: ETYOLOJİSİ VE ÖNLENMESİ. Journal of Science and Technology of Dumlupınar University(012), 127-132.

HAZİRAN 2020'den itibaren Journal of Scientific Reports-A adı altında ingilizce olarak yayın hayatına devam edecektir.