Frequency of intra uterine fetal deaths in Zonal Hospital of Puerto Madryn (Argentine) during the period 2014-2018
María Soledad Silva (1) Damián Leonardo Taire (2)
(1) Department of Neonatology, Zonal Hospital “Dr. Andrés R. Isola”, Puerto Madryn, Argentina (Chubut-Argentina); (2) Pediatric Pulmonology Office, Department of Pediatrics, Zonal Hospital “Dr. Andrés R. Isola” Puerto Madryn (Chubut-Argentina)
The Zonal Hospital “Dr. Andrés R. Isola”, serves an estimated population of 100.000 habitants. About 700 births occur in the hospital each year. The objective of this presentation is to determine the frequency of Intra Uterine Fetal Deaths (IUFD) in hospital births during the years 2014, 2015, 2016, 2017 and 2018.
Retrospective, cross-sectional, observational and descriptive design. The documentation consulted is compiled in the Births-Book, and in the Monthly Obstetric Summary. The data analyzed in both documents are: gestational age, birth weight in grams, condition at birth, end of pregnancy, previous pregnancies, sex, congenital anomalies, maternal pathologies and stillbirth autopsy. In this series, the IUFD refers to all losses of 22 or more weeks of gestation.
The occurrence of 30 IUFD was observed from January 2014 to December 2018, out of a total of 3062 live births. The Fetal Mortality Rate was 5.9 (2014), 6.1 (2015) 22.1 (2016), 5.3 (2017) and 10.2 (2018).The mean gestational age was 33.3 weeks. The average weight was 2118 grams. The mean maternal age was 26.5 years, multigravidae (2.3 previous pregnancies), way of ending pregnancy was cesarean section 60% and vaginal delivery 40%. With respect to the sex of IUFD: female sex 43.4%, male sex 50% and undetermined 6.6%. Congenital anomalies (CA) were observed in 4 dead fetuses (13.3%). They correspond to Potter sequence, trisomy 18 phenotype, unclassified CA.
The maternal pathologies associated were: placental detachment normoincerta 23.3%, pregnancy-induced hypertension 13.3%, chorioamnionitis 6.6%, gestational diabetes 6.6%, syphilis 6.6%, cholestasis 3.3% and risk of preterm birth with cerclage 3.3%. The stillbirth autopsy was performed in 7 cases (23%).
The frequency of IUFD in our series demonstrates an increase in cases during the years 2016 and 2018. It is inferred the need for early detection of maternal risk factors, to avoid IUFD.
The ethical approval for the study was granted by the Bioethics Committee of the Zonal Hospital of Trelew (Reference: 11/03/2019).