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Intrauterine fetal death and stillbirth: evaluations in a tertiary center

Yıl 2025, Cilt: 8 Sayı: 2, 186 - 190, 21.03.2025
https://doi.org/10.32322/jhsm.1608166

Öz

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.

Kaynakça

  • Management of stillbirth: obstetric care consensus no, 10. Obstet Gynecol. 2020;135(3):e110-e132. doi:10.1097/AOG.0000000000003719
  • Kulkarni VG, Sunilkumar KB, Nagaraj TS, et al. Maternal and fetal vascular lesions of malperfusion in the placentas associated with fetal and neonatal death: results of a prospective observational study. Am J Obstet Gynecol. 2021;225(6):660.e1-660.e12. doi:10.1016/j.ajog.2021.06.001
  • Hug L, You D, Blencowe H, et al. Global, regional, and national estimates and trends in stillbirths from 2000 to 2019: a systematic assessment. Lancet. 2021;398(10302):772-785. doi:10.1016/S0140-6736(21)01112-0
  • Waller JA, Saade G. Stillbirth and the placenta. Semin Perinatol. 2024; 48(1):151871. doi:10.1016/j.semperi.2023.151871
  • Deep JPR, Sharma S, Ansari RK, Shah RK, Raut PS. Evaluation of intrauterine fetal death at tertiary care centre: a descriptive cross-sectional study. Med Phoenix. 2022;7(2):10-16. doi:10.3126/medphoenix.v7i2.50777
  • Hwang KS, Parlberg L, Aceituno A, et al. Methodology to determine cause of death for stillbirths and neonatal deaths using automated case reports and a cause-of-death panel. Clin Infect Dis. 2021;73(Suppl_5):S368-S373. doi:10.1093/cid/ciab811
  • Tantengco OAG, Diwa MH, Millagrosa PMM, Velayo CL. Epidemiology and placental pathology of intrauterine fetal demise in a tertiary hospital in the Philippines. Eur J Obstet Gynecol Reprod Biol X. 2024;23:100338. doi:10.1016/j.eurox.2024.100338
  • Maslovich MM, Burke LM. Intrauterine Fetal Demise. StatPearls. Treasure Island (FL): StatPearls Publishing Copyright© 2022, StatPearls Publishing LLC.; 2022.
  • Heazell AEP, Siassakos D, Blencowe H, et al. Stillbirths: economic and psychosocial consequences. Lancet. 2016;387(10018):604-616. doi:10. 1016/S0140-6736(15)00836-3
  • Chang KT, Hossain P, Sarker M, Montagu D, Chakraborty NM, Sprockett A. Translating international guidelines for use in routine maternal and neonatal healthcare quality measurement. Glob Health Action. 2020;13(1):1783956. doi:10.1080/16549716.2020.1783956
  • Lawn JE, Blencowe H, Waiswa P, et al. Stillbirths: rates, risk factors, and acceleration towards 2030. Lancet. 2016;387(10018):587-603. doi:10. 1016/S0140-6736(15)00837-5
  • Jovanovic I, Ivanovic K, Kostic S, et al. Intrauterine fetal death in term pregnancy-a single tertiary clinic study. Life (Basel). 2023;13(12):2320. doi:10.3390/life13122320
  • Sharma B, Lahariya C, Majella MG, et al. Burden, differentials and causes of stillbirths in India: a systematic review and meta-analysis. Indian J Pediatr. 2023;90(Suppl 1):54-62. doi:10.1007/s12098-023-04749-9
  • İşgüder ÇK, Arslan O, Gunkaya OS, Kanat Pektas M, Tuğ N. Adolescent pregnancies in Turkey: a single center experience. Ann Saudi Med. 2024; 44(1):11-17. doi:10.5144/0256-4947.2024.11
  • Wilson DA, Mateus J, Ash E, Turan TN, Hunt KJ, Malek AM. The association of hypertensive disorders of pregnancy with infant mortality, preterm delivery, and small for gestational age. Healthcare (Basel). 2024;12(5):597. doi:10.3390/healthcare12050597
  • Vasconcelos A, Sousa S, Bandeira N, et al. Factors associated with perinatal and neonatal deaths in Sao Tome & Principe: a prospective cohort study. Front Pediatr. 2024;12:1335926. doi:10.3389/fped.2024. 1335926
  • Thakur A, Basnet P, Rai R, Agrawal A. Risk factors related to intrauterine fetal death. J Nepal Health Res Counc. 2019;17:46-50. doi:10.33314/jnhrc.v17i01.1534
  • Page JM, Allshouse AA, Cassimatis I, et al. Characteristics of stillbirths associated with diabetes in a diverse US. Cohort Obstet Gynecol. 2020; 136:1095-1102. doi:10.1097/AOG.0000000000004117
  • Cassimatis IR, Gibbins KJ, Dudley DJ, Silver RM, Smid MC. 965: causes and timing of stillbirth among women with pre-gestational and gestational diabetes: stillbirth collaborative research network data. Am J Obstet Gynecol. 2018;218:S571. doi:10.1016/j.ajog.2017.11.452
  • Patel O, Pradhan P, Das P, Mishra SK. Placental pathology and maternal risk factors for stillbirth: a case-control study. Cureus. 2023;15(5):e39339. doi:10.7759/cureus.39339
  • Amir H, Weintraub A, Aricha Tamir B, Apel Sarid L, Holcberg G, Sheiner E. A piece in the puzzle of intrauterine fetal death: pathological findings in placentas from term and preterm intrauterine fetal death pregnancies. J Matern Fetal Neonatal Med. 2009;22:759-764. doi:10. 3109/14767050902929396
  • Pinar H, Goldenberg RL, Koch MA, et al. Placental findings in singleton stillbirths. Pt 1Obstet Gynecol. 2014;123:325-336. doi:10.1097/AOG.000 0000000000100
  • McClure EM, Saleem S, Goudar SS, et al. Stillbirth 2010-2018: a prospective, population-based, multi-country study from the global network. Reprod Health. 2020;17:146. doi:10.1186/s12978-020-00991-y

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

Yıl 2025, Cilt: 8 Sayı: 2, 186 - 190, 21.03.2025
https://doi.org/10.32322/jhsm.1608166

Öz

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.

Kaynakça

  • Management of stillbirth: obstetric care consensus no, 10. Obstet Gynecol. 2020;135(3):e110-e132. doi:10.1097/AOG.0000000000003719
  • Kulkarni VG, Sunilkumar KB, Nagaraj TS, et al. Maternal and fetal vascular lesions of malperfusion in the placentas associated with fetal and neonatal death: results of a prospective observational study. Am J Obstet Gynecol. 2021;225(6):660.e1-660.e12. doi:10.1016/j.ajog.2021.06.001
  • Hug L, You D, Blencowe H, et al. Global, regional, and national estimates and trends in stillbirths from 2000 to 2019: a systematic assessment. Lancet. 2021;398(10302):772-785. doi:10.1016/S0140-6736(21)01112-0
  • Waller JA, Saade G. Stillbirth and the placenta. Semin Perinatol. 2024; 48(1):151871. doi:10.1016/j.semperi.2023.151871
  • Deep JPR, Sharma S, Ansari RK, Shah RK, Raut PS. Evaluation of intrauterine fetal death at tertiary care centre: a descriptive cross-sectional study. Med Phoenix. 2022;7(2):10-16. doi:10.3126/medphoenix.v7i2.50777
  • Hwang KS, Parlberg L, Aceituno A, et al. Methodology to determine cause of death for stillbirths and neonatal deaths using automated case reports and a cause-of-death panel. Clin Infect Dis. 2021;73(Suppl_5):S368-S373. doi:10.1093/cid/ciab811
  • Tantengco OAG, Diwa MH, Millagrosa PMM, Velayo CL. Epidemiology and placental pathology of intrauterine fetal demise in a tertiary hospital in the Philippines. Eur J Obstet Gynecol Reprod Biol X. 2024;23:100338. doi:10.1016/j.eurox.2024.100338
  • Maslovich MM, Burke LM. Intrauterine Fetal Demise. StatPearls. Treasure Island (FL): StatPearls Publishing Copyright© 2022, StatPearls Publishing LLC.; 2022.
  • Heazell AEP, Siassakos D, Blencowe H, et al. Stillbirths: economic and psychosocial consequences. Lancet. 2016;387(10018):604-616. doi:10. 1016/S0140-6736(15)00836-3
  • Chang KT, Hossain P, Sarker M, Montagu D, Chakraborty NM, Sprockett A. Translating international guidelines for use in routine maternal and neonatal healthcare quality measurement. Glob Health Action. 2020;13(1):1783956. doi:10.1080/16549716.2020.1783956
  • Lawn JE, Blencowe H, Waiswa P, et al. Stillbirths: rates, risk factors, and acceleration towards 2030. Lancet. 2016;387(10018):587-603. doi:10. 1016/S0140-6736(15)00837-5
  • Jovanovic I, Ivanovic K, Kostic S, et al. Intrauterine fetal death in term pregnancy-a single tertiary clinic study. Life (Basel). 2023;13(12):2320. doi:10.3390/life13122320
  • Sharma B, Lahariya C, Majella MG, et al. Burden, differentials and causes of stillbirths in India: a systematic review and meta-analysis. Indian J Pediatr. 2023;90(Suppl 1):54-62. doi:10.1007/s12098-023-04749-9
  • İşgüder ÇK, Arslan O, Gunkaya OS, Kanat Pektas M, Tuğ N. Adolescent pregnancies in Turkey: a single center experience. Ann Saudi Med. 2024; 44(1):11-17. doi:10.5144/0256-4947.2024.11
  • Wilson DA, Mateus J, Ash E, Turan TN, Hunt KJ, Malek AM. The association of hypertensive disorders of pregnancy with infant mortality, preterm delivery, and small for gestational age. Healthcare (Basel). 2024;12(5):597. doi:10.3390/healthcare12050597
  • Vasconcelos A, Sousa S, Bandeira N, et al. Factors associated with perinatal and neonatal deaths in Sao Tome & Principe: a prospective cohort study. Front Pediatr. 2024;12:1335926. doi:10.3389/fped.2024. 1335926
  • Thakur A, Basnet P, Rai R, Agrawal A. Risk factors related to intrauterine fetal death. J Nepal Health Res Counc. 2019;17:46-50. doi:10.33314/jnhrc.v17i01.1534
  • Page JM, Allshouse AA, Cassimatis I, et al. Characteristics of stillbirths associated with diabetes in a diverse US. Cohort Obstet Gynecol. 2020; 136:1095-1102. doi:10.1097/AOG.0000000000004117
  • Cassimatis IR, Gibbins KJ, Dudley DJ, Silver RM, Smid MC. 965: causes and timing of stillbirth among women with pre-gestational and gestational diabetes: stillbirth collaborative research network data. Am J Obstet Gynecol. 2018;218:S571. doi:10.1016/j.ajog.2017.11.452
  • Patel O, Pradhan P, Das P, Mishra SK. Placental pathology and maternal risk factors for stillbirth: a case-control study. Cureus. 2023;15(5):e39339. doi:10.7759/cureus.39339
  • Amir H, Weintraub A, Aricha Tamir B, Apel Sarid L, Holcberg G, Sheiner E. A piece in the puzzle of intrauterine fetal death: pathological findings in placentas from term and preterm intrauterine fetal death pregnancies. J Matern Fetal Neonatal Med. 2009;22:759-764. doi:10. 3109/14767050902929396
  • Pinar H, Goldenberg RL, Koch MA, et al. Placental findings in singleton stillbirths. Pt 1Obstet Gynecol. 2014;123:325-336. doi:10.1097/AOG.000 0000000000100
  • McClure EM, Saleem S, Goudar SS, et al. Stillbirth 2010-2018: a prospective, population-based, multi-country study from the global network. Reprod Health. 2020;17:146. doi:10.1186/s12978-020-00991-y
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Fetal Gelişim ve Tıp, Kadın Hastalıkları ve Doğum
Bölüm Orijinal Makale
Yazarlar

Osman Samet Günkaya 0000-0002-2188-2503

Seher Koyuncu 0000-0001-5944-6195

Yayımlanma Tarihi 21 Mart 2025
Gönderilme Tarihi 27 Aralık 2024
Kabul Tarihi 24 Ocak 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 8 Sayı: 2

Kaynak Göster

AMA Günkaya OS, Koyuncu S. Intrauterine fetal death and stillbirth: evaluations in a tertiary center. J Health Sci Med /JHSM /jhsm. Mart 2025;8(2):186-190. doi:10.32322/jhsm.1608166

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