İntrauterin fetal ölüm ve ölü doğum: üçüncü basamak bir merkezde değerlendirmeler

Abstract

Amaçlar: Rutin doğum öncesi bakıma rağmen, intrauterin fetal ölüm (IUFD) öngörülemezdir. Erken tanı ve maternal ve obstetrik sorunların hızlı tedavisi ile IUFD daha az yaygın hale gelebilir. Bu çalışmanın amacı, üçüncü basamak bir bakım merkezindeki gebe hastalarda IUFD prevalansını belirlemekti. Yöntemler: Ocak 2020 ile Ağustos 2024 arasında üçüncü basamak bir merkezde tanımlayıcı kesitsel bir çalışma yürütüldü ve Kurumsal İnceleme Kurulu ve Etik Komitesi tarafından onaylandı (hibe numarası: E-46059653-050.04-259016740). Gebe kadınların demografik özellikleri, tıbbi ve obstetrik komplikasyon oranları ve plasentanın histopatolojik bulguları kaydedildi. Sonuçlar: 20.356 doğumun 137'sinde (%0,67) IUFD tanısı konuldu. Bunlardan 104 vaka çalışmaya dahil edildi. Ölü doğum oranının en yüksek olduğu dönem 28-33 haftalar arasında %36,3 olup, gebe kadınların %46,2'si primipar ve %77,9'u 20-24 yaş arasındadır. En sık görülen maternal sorunlar maternal anemi %37,5, açıklanamayan obstetrik sorunlar %39,4 ve preeklampsi %11,5 olup, sezaryenle doğum yapan annelerin %37,5'i bu sorunla karşılaşmıştır. En sık görülen plasental histopatolojik incelemeler plasental enfarkt %25 olmuştur. Sonuç: Hastaların ve toplumun rutin doğum öncesi bakımı, risk gruplarının yakın takibi ve gebe kadınların eğitilmesiyle önemli miktarda IUFD önlenebilir.

Keywords

• fetal ölüm
• intrauterin fetal ölüm
• perinatal ölümler
• ölü doğum.

Intrauterine fetal death and stillbirth: evaluations in a tertiary center

Abstract

Aims: Despite routine prenatal care, intrauterine fetal death (IUFD) is unpredictable. With early diagnosis and prompt treatment of maternal and obstetric problems, IUFD may become less common. The aim of this study was to determine the prevalence of IUFD in pregnant patients in a tertiary care center. Methods: A descriptive cross-sectional study was conducted at a tertiary center from January 2020 to August 2024 and was approved by the Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital Scientific Research Ethics Committee (Date: 08.11.2024, Decision No: 2024/318). Demographic characteristics of pregnant women, medical and obstetric complication rates, and histopathological findings of the placenta were recorded. Results: IUFD was diagnosed in 137 of 20,356 deliveries (0.67%). Of these, 104 cases were included in the study. The period with the highest stillbirth rate was 28-33 weeks (36.3%), 46.2% of pregnant women gave birth for the first time and 77.9% were between the ages of 20-24. The most common maternal problems were maternal anemia (n=39, 37.5%). The most common perinatal outcomes were preeclampsia/eclampsia (n=12, 11.5%) and the rate of pregnant women without any perinatal problems was 57.7% (n=60). The caesarean section rate was 37.5% (n=39). In addition, the most common placental histopathological examinations were placental infarction (n=26, 25%). Conclusion: A significant amount of IUFD can be prevented with routine prenatal care of patients and society, close monitoring of risk groups, and educating pregnant women.

Keywords

• Fetal demise
• intrauterine fetal death
• perinatal deaths
• stillbirth

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