Panduro BJG, Vázquez GMD, Pérez MJJ, Castro HJF

Language: Spanish
References: 9
Page: 573-579
PDF size: 274.96 Kb.

ABSTRACT

Objective: To identify the sociodemographics, obstetrical and perinatology factors of risk most frequently associated to fetal death in greater pregnancies of 27 weeks.
Patients and methods: From January 2001 to May 2005, in the Hospital Civil de Guadalajara Dr Juan I. Menchaca, we carried out a study of cases and controls with 450 cases of fetal death of more than 27 weeks of gestation and 450 newborn alive whose birth happened immediately later. We compared the frequency of different maternal and fetal variables that in previous forms was associated with fetal death, by means of Chi squared test and exact test of Fisher, the association among these variables and fetal death with the reason of momios was considered. In all the cases the chosen interval of confidence was of 95%.
Results: The risk factors associated with fetal death were: maternal age over 35 years, low schooling, multiparity, antecedent of abortion and fetal death, deficient prenatal care, complications in the pregnancy, abnormal amniotic fluid, double circular of umbilical cord to neck of the product and great congenital malformations of newborn. It was not associated with fetal death, the single marital status, primigesta, smoking, male sex of the fetus, simple circulate of umbilical cord to the neck and fetal macrosomia.
Conclusions: Of the risk factors associated with fetal death, the main one is a deficient prenatal care, that of being improved, might diminish the association of some other variables that were associated with fetal death.

REFERENCES

1. Spong CY. Vigilancia fetal. En: Scott JR, Gibbs RS, Parlan BY, Haney AF, editores. Tratado de Obstetricia y Ginecología de Danforth. 9a ed. México: McGraw-Hill Interamericana, 2005;pp:167-80.

2. Sheiner E, Hallak M, Shoham-Vardi I, Goldstein D, Mazor M, Katz M. Determining risk factors for intrapartum fetal death. J Reprod Med 2000;45:419-24.

3. Aquino MM, Cecatti JG, Mariani-Neto C. Risk factors associated to fetal death. Sao Paulo Med J 1998;116:1852-7.

4. Frias AE, Luikenaar RA, Sullivan AE, Lee RM, Porter TF, Branch DW, Silver RM. Poor obstetric outcome in subsequent pregnancies in women with prior fetal death. Obstet Gynecol 2004;104: 521-6.

5. Kahn B, Lumey LH, Zybert PA, Lorenz JM, Cleary-Goldman J, Dalton ME, Robinson JN. Prospective risk of fetal death in singleton, twin, and triplet gestations: implications for practice. Obstet Gynecol 2003;102:685-92.

6. Gardosi J, Badger S, Tonks A, Francis A. Unexplained stillbirths: An investigation of the clinically relevant conditions at the time of fetal death. Am J Obstet Gynecol 2003;189:158.

7. Romero GG, Martínez C, Ponce A, Abrego E. Factores de riesgo y muerte fetal anteparto. Ginecol Obstet Mex 2004;72:109-15.

8. Larson JD, Rayburn WF, Harlan VL. Nuchal cord entanglements and gestational age. Am J Perinatol 1997;14:555-7.

9. Mondestin MA, Ananth CV, Smulian JC, Vintzileos AM. Birth weight and fetal death in the United States. The effect of maternal diabetes during pregnancy. Am J Obstet Gynecol 2002;187:922-6.