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Kliniğimizde Gerçekleşen İntra-Uterin Fetal Ölüm Vakalarının Retrospektif Olarak Değerlendirilmesi

Yıl 2023, Cilt: 10 Sayı: 3, 155 - 159, 19.12.2023
https://doi.org/10.47572/muskutd.1294429

Öz

Tersiyer bir merkez olan kliniğimizde, 2015-2022 yılları arasında doğumu gerçekleşen intra-uterin fetal ölüm vakalarının sıklığını, demografik özelliklerini, risk faktörlerini ve sonuçlarını retrospektif olarak değerlendirmek. Ocak 2015-Aralık 2021 tarihleri arasında Muğla Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum Kliniğinde intra-uterin fetal ölüm nedeni ile doğumu gerçekleşen, 22-41 hafta arasındaki, 92 gebe değerlendirildi. Gebelerin başvuru anındaki yaş, gravida, parite, vücut kitle indeksi (VKİ) verileri, gebelik haftaları, doğum sonrası ise doğum ağırlıkları, doğum şekilleri, bebek cinsiyeti ve patolojik inceleme sonuçları kayıt edildi. Belirtilen tarihler arasında 92 intra-uterin fetal ölüm gerçekleşmiştir. Doğum sayısına oranı 1.03% olarak saptanmıştır. 88 (%95.65) tanesi tekil gebelik, 4 (%4.34) tanesi çoğul gebelik idi. Yaş ortalamaları 29.47±5.71 idi. 1’er (%1.08) gebe 18 yaşın altında ve 40 yaşın üzerine idi. VKİ ortalamaları 25.54±3.90 kg/m2 iken, 2 (%2.16) gebenin VKİ’si morbid obez (≥40 kg/m2) seviyesinde izlenmiştir. Gestasyonel yaşları 31.07±4.87 hafta idi. İntra-uterin fetal ölüm nedenleri değerlendirildiğinde, 12 (%13.18) gebede plasenta dekolmanı saptanmıştır. Plasenta dekolmanı saptanan gebelerin 6 (%50)’sinde gebeliğin hipertansif bozuklukları mevcuttu. 5 (%5.49) gebede diabetes mellitus, 2 (%2.19) gebede plasenta previa saptanmıştır. 7 (%7.60) gebenin yatışında uteroplasental yetmezlik bulgusu olan anhidroamniyoz saptandı. 20 (%21.97) gebede fetal anomali izlenmiştir. 1 (%1.09) gebede dissemine intravasküler koagülasyon gelişmiştir. 3 (3.26%) gebede ise COVID-19 saptanmış olup hospitalize edilmiştir. İntra-uterin fetal ölüm vakalarının ön görülebilirliği düşüktür. Fakat bu duruma rağmen, her merkez kendi sonuçlarını değerlendirerek ve risk faktörlerini belirleyerek pro-aktif yaklaşım ile intra-uterin fetal ölüm vakalarını kısmi olarak azaltabilir.

Kaynakça

  • 1. Joseph K, Kinniburgh B, Hutcheon JA, et al. Rationalizing definitions and procedures for optimizing clinical care and public health in fetal death and stillbirth. Obstet Gynecol. 2015;125(4):784-8.
  • 2. WHO. International Statistical Classification of Diseases and related health problems: Alphabetical index: World Health Organization; 2004.
  • 3. Manocha A, Ravikumar G, Crasta J. Placenta in intrauterine fetal demise (IUFD): a comprehensive study from a tertiary care hospital. J Matern Fetal Neonatal Med. 2019;32(23):3939-47.
  • 4. Silver RM, Varner MW, Reddy U, et al. Work-up of stillbirth: a review of the evidence. Am J Obstet Gynecol. 2007;196(5):433-44.
  • 5. Lavezzi AM, Piscioli F, Pusiol T, et al. Sudden intrauterine unexplained death: time to adopt uniform postmortem investigative guidelines? BMC Pregnancy Childbirth. 2019;19(1):1-11.
  • 6. TNSA 2018. Türkiye Nüfus ve Sağlık Araştırması Temel Bulgular. 2019.
  • 7. Kanmaz AG, Beyan E, Töz E, et al. Ölü doğumun öngörülmesinde maternal sosyodemografik durum ve ilk trimester tarama testinin yeri. İzmir Tepecik Eğit Araşt Hast Derg. 2021;31(2):169-74.
  • 8. Matturri L, Pusiol T, Lavezzi A. Proposal of the acronym “SIUDS” for unexplained stillbirths, like “SIDS”. J Neonatal Biol. 2014;3(5):2167-0897.
  • 9. De Graaff E, Wijs L, Leemaqz S, et al. Risk factors for stillbirth in a socio-economically disadvantaged urban Australian population. J Matern Fetal Neonatal Med. 2017;30(1):17-22.
  • 10. Sharma S, Sidhu H, Kaur S. Analytical study of intrauterine fetal death cases and associated maternal conditions. Int J Appl Basic Med Res. 2016;6(1):11-3.
  • 11. Ohana O, Holcberg G, Sergienko R, et al. Risk factors for intrauterine fetal death (1988–2009). J Matern Fetal Neonatal Med. 2011;24(9):1079-83.
  • 12. Wojcieszek AM, Shepherd E, Middleton P, et al. Interventions for investigating and identifying the causes of stillbirth. Cochrane Database Syst Rev. 2018;4(4): CD012504.
  • 13. Kıncı ÖŞ, Kıncı MF, Mirzazade F, et al. Maternal and neonatal outcomes of pregnant women with SARS-CoV-2 infection in our tertiary hospital. J Perinatol. 2022;30(3):301-7.
  • 14. Fretts RC. Etiology and prevention of stillbirth. Am J Obstet Gynecol. 2005;193(6):1923-35.
  • 15. Imdad A, Yakoob MY, Siddiqui S, et al. Screening and triage of intrauterine growth restriction (IUGR) in general population and high risk pregnancies: a systematic review with a focus on reduction of IUGR related stillbirths. BMC public health. 2011;11(3):1-12.
  • 16. Chakhtoura NA, Reddy UM. Management of stillbirth delivery. Seminars in perinatology; 2015: Elsevier.
  • 17. Eyi EGY, Mollamahmutoglu L. An analysis of the high cesarean section rates in Turkey by Robson classification. J Matern Fetal Neonatal Med. 2021;34(16):2682-92.
  • 18. Ulubay M, Öztürk M, Fidan U, et al. Skin incision lengths in caesarean section. Cukurova Med J. 2016;41(1):82-6.
  • 19. Silver RM. Examining the link between placental pathology, growth restriction, and stillbirth. Best Pract Res Clin Obstet Gynaecol. 2018;49:89-102.
  • 20. Kafadar ÖO, Tekin ÖM, Çoşkun B, et al. Investigating demographic, socioeconomic, and obsteric risk factors of term intrauterine stillbirth cases. Med Sci Discov. 2019;6(7):128-32.
  • 21. Rose C, Evans M, Tooley J. Falling rates of perinatal postmortem examination: are we to blame? Arch Dis Child Fetal Neonatal Ed. 2006;91(6):F465.
  • 22. Keskin U, Kıncı MF. Adolesan dönemi ve gebelikler. Turkiye Klinikleri J Fam Med-Special Topics. 2018;9(5):33-8.
  • 23. Walker KF, Thornton JG. Advanced maternal age. Obstet Gynaecol Reprod Med. 2016;26(12):354-7.
  • 24. Kıncı M, Şehirli Kıncı Ö, Karaşahin KE. The effect of bishop score and posterior cervical angle on the success of birth induction due to over 41 weeks pregnancy. Ege Klin Tıp Derg. 2021;59(3):1-8.
  • 25. Galal M, Symonds I, Murray H, et al. Postterm pregnancy. Facts Views Vis Obgyn. 2012;4(3):175.

A Retrospective Analysis of Intra-Uterine Fetal Demise Cases in Our Clinic

Yıl 2023, Cilt: 10 Sayı: 3, 155 - 159, 19.12.2023
https://doi.org/10.47572/muskutd.1294429

Öz

The present study aims to retrospectively analyze the frequency, demographic characteristics, affecting risk factors and outcomes of intra-uterine fetal death (IUFD) cases delivered between 2015 and 2022 in our clinic, a tertiary center. Between January 2015 and December 2021, 92 pregnant women between 22-41 weeks of gestational age who gave birth due to IUFD in Muğla University Education and Research Hospital clinic were included in the study. Age at presentation, gravida, parity and body mass index (BMI) data, gestational weeks, and if after birth, birth weight, mode of delivery, infant sex and pathologic examination results were recorded. There were 92 cases of IUFD between the specified dates. The ratio of cases to the number of births was 1.03%. Of the cases, 88 (95.65%) were singleton pregnancies and 4 (4.34%) were multiple pregnancies. The mean age was 29.47±5.71 years. Among the cases, 1 (1.08%) pregnant woman was under 18 years of age and 1 pregnant woman was over 40 years of age. The mean BMI was 25.54±3.90 kg/m2 and 2 (2.16%) pregnant women were morbidly obese (≥40 kg/m2). The mean gestational age was 31.07±4.87 weeks. When the causes of IUFD were evaluated, placental abruptio1n was observed in 12 (13.18%) pregnant women. Hypertensive disorders of pregnancy were present in 6 (50%) of the pregnant women with placental abruption. While 5 (5.49%) pregnant women had diabetes mellitus, 2 (2.19%) had placenta previa. A total of 7 (7.60%) pregnant women had anhydroamniosis, a sign of uteroplacental insufficiency, during hospitalization, while 20 (21.97%) pregnant women had fetal anomaly. One (1.09%) pregnant woman developed disseminated intravascular coagulation. In addition, 3 (3.26%) pregnant women had COVID-19 and were hospitalized. The predictability of IUFD cases is low. But despite this, each center can partially reduce the incidence of IUFD with a pro-active approach by evaluating its own outcomes and identifying risk factors.

Kaynakça

  • 1. Joseph K, Kinniburgh B, Hutcheon JA, et al. Rationalizing definitions and procedures for optimizing clinical care and public health in fetal death and stillbirth. Obstet Gynecol. 2015;125(4):784-8.
  • 2. WHO. International Statistical Classification of Diseases and related health problems: Alphabetical index: World Health Organization; 2004.
  • 3. Manocha A, Ravikumar G, Crasta J. Placenta in intrauterine fetal demise (IUFD): a comprehensive study from a tertiary care hospital. J Matern Fetal Neonatal Med. 2019;32(23):3939-47.
  • 4. Silver RM, Varner MW, Reddy U, et al. Work-up of stillbirth: a review of the evidence. Am J Obstet Gynecol. 2007;196(5):433-44.
  • 5. Lavezzi AM, Piscioli F, Pusiol T, et al. Sudden intrauterine unexplained death: time to adopt uniform postmortem investigative guidelines? BMC Pregnancy Childbirth. 2019;19(1):1-11.
  • 6. TNSA 2018. Türkiye Nüfus ve Sağlık Araştırması Temel Bulgular. 2019.
  • 7. Kanmaz AG, Beyan E, Töz E, et al. Ölü doğumun öngörülmesinde maternal sosyodemografik durum ve ilk trimester tarama testinin yeri. İzmir Tepecik Eğit Araşt Hast Derg. 2021;31(2):169-74.
  • 8. Matturri L, Pusiol T, Lavezzi A. Proposal of the acronym “SIUDS” for unexplained stillbirths, like “SIDS”. J Neonatal Biol. 2014;3(5):2167-0897.
  • 9. De Graaff E, Wijs L, Leemaqz S, et al. Risk factors for stillbirth in a socio-economically disadvantaged urban Australian population. J Matern Fetal Neonatal Med. 2017;30(1):17-22.
  • 10. Sharma S, Sidhu H, Kaur S. Analytical study of intrauterine fetal death cases and associated maternal conditions. Int J Appl Basic Med Res. 2016;6(1):11-3.
  • 11. Ohana O, Holcberg G, Sergienko R, et al. Risk factors for intrauterine fetal death (1988–2009). J Matern Fetal Neonatal Med. 2011;24(9):1079-83.
  • 12. Wojcieszek AM, Shepherd E, Middleton P, et al. Interventions for investigating and identifying the causes of stillbirth. Cochrane Database Syst Rev. 2018;4(4): CD012504.
  • 13. Kıncı ÖŞ, Kıncı MF, Mirzazade F, et al. Maternal and neonatal outcomes of pregnant women with SARS-CoV-2 infection in our tertiary hospital. J Perinatol. 2022;30(3):301-7.
  • 14. Fretts RC. Etiology and prevention of stillbirth. Am J Obstet Gynecol. 2005;193(6):1923-35.
  • 15. Imdad A, Yakoob MY, Siddiqui S, et al. Screening and triage of intrauterine growth restriction (IUGR) in general population and high risk pregnancies: a systematic review with a focus on reduction of IUGR related stillbirths. BMC public health. 2011;11(3):1-12.
  • 16. Chakhtoura NA, Reddy UM. Management of stillbirth delivery. Seminars in perinatology; 2015: Elsevier.
  • 17. Eyi EGY, Mollamahmutoglu L. An analysis of the high cesarean section rates in Turkey by Robson classification. J Matern Fetal Neonatal Med. 2021;34(16):2682-92.
  • 18. Ulubay M, Öztürk M, Fidan U, et al. Skin incision lengths in caesarean section. Cukurova Med J. 2016;41(1):82-6.
  • 19. Silver RM. Examining the link between placental pathology, growth restriction, and stillbirth. Best Pract Res Clin Obstet Gynaecol. 2018;49:89-102.
  • 20. Kafadar ÖO, Tekin ÖM, Çoşkun B, et al. Investigating demographic, socioeconomic, and obsteric risk factors of term intrauterine stillbirth cases. Med Sci Discov. 2019;6(7):128-32.
  • 21. Rose C, Evans M, Tooley J. Falling rates of perinatal postmortem examination: are we to blame? Arch Dis Child Fetal Neonatal Ed. 2006;91(6):F465.
  • 22. Keskin U, Kıncı MF. Adolesan dönemi ve gebelikler. Turkiye Klinikleri J Fam Med-Special Topics. 2018;9(5):33-8.
  • 23. Walker KF, Thornton JG. Advanced maternal age. Obstet Gynaecol Reprod Med. 2016;26(12):354-7.
  • 24. Kıncı M, Şehirli Kıncı Ö, Karaşahin KE. The effect of bishop score and posterior cervical angle on the success of birth induction due to over 41 weeks pregnancy. Ege Klin Tıp Derg. 2021;59(3):1-8.
  • 25. Galal M, Symonds I, Murray H, et al. Postterm pregnancy. Facts Views Vis Obgyn. 2012;4(3):175.
Toplam 25 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Cerrahi
Bölüm Araştırma Makalesi
Yazarlar

Özge Şehirli Kıncı 0000-0001-6439-0798

Firangiz Mirzazada 0000-0003-0677-3584

Mehmet Onur Arslaner 0000-0002-1573-8556

İsmail Gökbel 0000-0002-6034-8987

Yayımlanma Tarihi 19 Aralık 2023
Gönderilme Tarihi 9 Mayıs 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 10 Sayı: 3

Kaynak Göster

APA Şehirli Kıncı, Ö., Mirzazada, F., Arslaner, M. O., Gökbel, İ. (2023). A Retrospective Analysis of Intra-Uterine Fetal Demise Cases in Our Clinic. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, 10(3), 155-159. https://doi.org/10.47572/muskutd.1294429
AMA Şehirli Kıncı Ö, Mirzazada F, Arslaner MO, Gökbel İ. A Retrospective Analysis of Intra-Uterine Fetal Demise Cases in Our Clinic. MMJ. Aralık 2023;10(3):155-159. doi:10.47572/muskutd.1294429
Chicago Şehirli Kıncı, Özge, Firangiz Mirzazada, Mehmet Onur Arslaner, ve İsmail Gökbel. “A Retrospective Analysis of Intra-Uterine Fetal Demise Cases in Our Clinic”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 10, sy. 3 (Aralık 2023): 155-59. https://doi.org/10.47572/muskutd.1294429.
EndNote Şehirli Kıncı Ö, Mirzazada F, Arslaner MO, Gökbel İ (01 Aralık 2023) A Retrospective Analysis of Intra-Uterine Fetal Demise Cases in Our Clinic. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 10 3 155–159.
IEEE Ö. Şehirli Kıncı, F. Mirzazada, M. O. Arslaner, ve İ. Gökbel, “A Retrospective Analysis of Intra-Uterine Fetal Demise Cases in Our Clinic”, MMJ, c. 10, sy. 3, ss. 155–159, 2023, doi: 10.47572/muskutd.1294429.
ISNAD Şehirli Kıncı, Özge vd. “A Retrospective Analysis of Intra-Uterine Fetal Demise Cases in Our Clinic”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 10/3 (Aralık 2023), 155-159. https://doi.org/10.47572/muskutd.1294429.
JAMA Şehirli Kıncı Ö, Mirzazada F, Arslaner MO, Gökbel İ. A Retrospective Analysis of Intra-Uterine Fetal Demise Cases in Our Clinic. MMJ. 2023;10:155–159.
MLA Şehirli Kıncı, Özge vd. “A Retrospective Analysis of Intra-Uterine Fetal Demise Cases in Our Clinic”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, c. 10, sy. 3, 2023, ss. 155-9, doi:10.47572/muskutd.1294429.
Vancouver Şehirli Kıncı Ö, Mirzazada F, Arslaner MO, Gökbel İ. A Retrospective Analysis of Intra-Uterine Fetal Demise Cases in Our Clinic. MMJ. 2023;10(3):155-9.