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ISSN 2007-3194 (Print)
Órgano de difusión oficial del Instituto Materno Infantil del Estado de México

2012, Number 2

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Arch Inv Mat Inf 2012; 4 (2)

Índice de muerte fetal tardía y factores de riesgo obstétricos, perinatales y socioeconómicos asociados

Trejo VKX, Ávila EJF, Pardo MRV

Language: Spanish
References: 28
Page: 71-78
PDF size: 77.15 Kb.


ABSTRACT

Background: The late stillbirth rate in Mexico has had a decline in the last ten years, but is considered a public health problem. We conducted an assay to determine the rate of late stillbirth and risk factors for obstetric, perinatal and socioeconomic factors associated in the Hospital of Gynecology and Obstetrics Maternal-Child Institute of the State of Mexico (IMIEM) in the period from January 2009 to December 2010. Materials and methods: Observational, prospective, descriptive and transversal of 72 late stillbirth that occurred in the Hospital of Gynecology and Obstetrics Maternal-Child Institute of the State of Mexico in the period from January 2009 to December 2010. Was obtained from birth registration in the period from January 2009 to December 2010, and determined the rate of stillbirth. We obtained the obstetric risk factors, perinatal and socioeconomic each case by collecting data directly to the mother and later corroborated by the clinical record. Results: The stillbirth rate in the Hospital of Gynecology and Obstetrics Maternal-Child Institute of the State of Mexico in 2009 was 4.45 late fetal deaths per 1,000 live births with a decrease of 3.08 in 2010 late fetal deaths per 1,000 live births. The prevailing socioeconomic risk factors of the patients was the high school level and middle income. Of obstetric risk factors, the average age of the patient with late fetal death was 25.5 years, it is multigravida mothers (44.4%), overweight (48.6%) with no history of systemic disease and poor antenatal care with only an average of 4.29 consultations received; factors related to perinatal death products were obtained with low weight for gestational age in a high percentage (37.5%) with a total of 2208 g average weight, prematurity in 47.2%, oligohydramnios at a rate of 12.% and liquid meconium in 30.6%. The predominant sex of cases of late fetal death was the male and the way the resolution was vaginal in 97.2% of cases. Conclusions: Risk factors that prevailed in the case of patients with intrauterine death were low weight for gestational age, prematurity and poor prenatal care received, they reflect the importance of seeking health strategies that allow to provide a higher quality prenatal and thus the detection and treatment of pathologies such as intrauterine growth restriction highly associated with multiple alterations in fetal death and neonatal outcomes.


REFERENCES

  1. Huertas-Tachino E. Epidemiología de las muertes fetales ocurridas en el Instituto Especializado Materno Perinatal, 2003, Rev Per Ginecol Obstet, 2007; 53: 199-202.

  2. Norma Oficial Mexicana NOM-007-SSA2-1993, Atención de la mujer durante el embarazo, parto, puerperio y del recién nacido. Criterios y procedimientos para prestación del servicio. En: http://www.salud.gob.mx/unidades/cdi/nom/007ssa23.html

  3. Hernández GMJ, Puente AMJ. Muerte fetal anteparto sine cause. En: Cabero Roura L. Tratado de ginecología, obstetricia y medicina de la reproducción. 2ª ed. Madrid: Editorial Médica Panamericana; 2006: 959-966.

  4. Vogelmann RA, Sánchez JE, Sartori MF. Muerte fetal intrauterina, Revista de Postgrado de la VI Cátedra de Medicina UNNE, 2008 (fecha de acceso 18 enero 2011); 188. URL disponible en: http//med.unne.edu.ar/revista/revista 188/4_188pdf

  5. Silver RM, Varner MW, Reddy U, Goldenberg R, Pinar H, Conway D, Bukowski R, Carpenter M, Hogue C, Willinger M, Dudley D, Saade G, Stoll B. Work-up of stillbirth: a review of the evidence, Am J Obstet Gynecol, 2007; 196 (5): 433-444.

  6. González P, Puertas A, Mercé LT. Muerte fetal intrauterina. En: Bajo AJM, Melchor MJC, Mercé L. Fundamentos de Obstetricia de SEGO. Madrid, 2007: 935-942.

  7. Feldman DM, Timms D, Borgida AF. Toxoplasmosis, parvovirus and cytomegalovirus in pregnancy, Clin Lab Med, 2010; 30: 709-720.

  8. Goldenberg RL, Thompson C. The infectious origins of stillbirth, Am J Obstet Gynecol, 2003; 189: 861-873.

  9. Donald DJ. Muerte intraútero asociada con la diabetes: incidencia, fisiopatología y prevención, Obstet Gynec Clin N Am, 2007; 34: 293-307.

  10. Gabee SG, Graves CR. Management of diabetes mellitus complicating pregnancy, Obstet Gynecol, 2003; 102: 857-868.

  11. Sepúlveda J, Quintero EM. Muerte fetal inexplicada, Rev Col Obs Gin, 2004; 55: 300-307.

  12. Basso O, Rasmussen S, Weinberg CR, Wilcox AJ, Irgens L, Skjaerven R. Trends in fetal and infant survival following preeclampsia, JAMA, 2006; 296: 1357-1362.

  13. Wang X, Gomutputra P, Wolgemuth DJ, Baxi L. Effects of acute alcohol intoxication in the second trimester of pregnancy on development of the murine fetal lung, Am J Obstet Gynecol, 2007; 197: 269.e1-269.e4.

  14. Aliyu MH, Salihu HM, Alio AP, Wilson RE, Chakrabarty S, Clayton HB. Prenatal smoking among adolescents and risk of fetal demise before and during labor, J Pediatr Adolesc Gynecol, 2010; 23: 129-135.

  15. Weiss HB, Songer TJ, Fabio A. Fetal deaths related to maternal injury, JAMA, 2001; 286: 1863-1868.

  16. Meroz Y, Elchalal U, Ginosar Y. Initial trauma management in advanced pregnancy, Anesthesiology Clin, 2007; 25: 117-129.

  17. Sadro C, Bittle M, O’Connell K. Imaging the pregnant trauma patient, Ultrasound Clin, 2011; 6: 97-103.

  18. Rappaport VJ. Prenatal diagnosis and genetic screening integration into prenatal care, Obstet Gynecol Clin N Am, 2008; 35: 435-458.

  19. Ananth V, Berkowitz GS, Savitz DA, Lapinski L. Placental abruption and adverse perinatal outcomes, JAMA, 1999; 282: 1646-1651.

  20. Druzin Ml, James S Jr. Antepartum. In: Gabbe SC, Niebyl JR, Simpson JL, eds. Obstetrics: normal and problem pregnancies, 5th ed. Philadelphia, Pa: Elsevier Churchill Livinsgtong; 2007: 267-300.

  21. Salihu HM, Aliyu MH, Rouse DJ, Kirby RS, Alexander GR. Potentially preventable excess mortality among higher-order multiples, Obstet Gynecol, 2003; 102: 679-684.

  22. Habli MLFY, Crombleholme T. Twin-to-twin transfusion syndrome: a comprehensive update, Clin Perinatol, 2009; 36: 391-416.

  23. Schenone MH, Mari G. The MCA Doppler and its role in the evaluation of fetal anemia and fetal growth restriction, Clin Perinatol, 2011; 38: 83-102.

  24. Panduro-Barón JG, Vázquez-Granados MD, Pérez-Molina JJ, Castro-Hernández JF. Factores de riesgo prenatal en la muerte fetal tardía, Ginecol Obstet Mex, 2006; 74: 573-579.

  25. Haavaldsen C, Sarfraz AA, Samuelsen SO, Eskild A. The impact of maternal age on fetal death: does length of gestation matter? Am J Obstet Gynecol 2010; 203: 554.e1-554.e8.

  26. Spyropoulou AC, Tsartsara EI, Angelopoulou A, Zervas IM. Psychiatric manifestations preceding fetal death in antiphospholipid syndrome, Gen Hosp Psychiatry, 2010; 32: 225-227.

  27. Brenner B, Aharon A. Thrombophilia and adverse pregnancy outcome, Clin Perinatol, 2007; 34: 527-541.

  28. Horn LC, Langner A, Stiehl P, Wittekind C, Faber R. Identification of the causes of intrauterine death during 310 consecutive autopsies, Eur J Obstet Gynecol Reprod Biol, 2004; 113: 134-138.




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