Robalo Raquel, Pedroso Célia, Amaral Njila, Soares Clara
Department of Obstetrics and Gynecology, Alfredo da Costa Maternity, Lisbon, Portugal.
Acta Med Port. 2013 Jan-Feb;26(1):39-42. Epub 2013 Apr 24.
Late fetal death is a desolating event that inspite the effort to implement new surveillance protocols in perinatal continues to defy our clinical pratice.
To examine etiological factors contributing to main causes and conditions associated with fetal death in late pregnancies over a 10-year period.
Retrospective cohort analysis of 208 late singleton stillbirth delived in a tertiary-perinatal referral maternity over a 10-year period. Clinical charts, laboratory data and feto-placental pathology findings were systematically reviewed.
The incidence of late fetal demise was 3.5 per 1000 pregnancies. No significant trend in the incidence of stillbirth was demonstrated during the study period. Stillbirth was intrapartum in 12 (5.8%) cases and 72 (35%) were term pregnancies. Fourteen percent of cases were undersurveilled pregnancies. Mean gestacional age at diagnosis was 34 weeks. The primary cause of death was fetal, it was present in 59 cases, 25% were considered small for gestational age. Stillbirths were unexplained in 24.5% of cases. Maternal medical disorders were identified in 21%. Hypertensive disorders were frequent and associated with early gestacional age (p = 0.028).
There was no change in the incidence of late stillbirth during the 10 years under evaluation. The incidence was 3.5 ‰ which was identical to that described in developed countries. About one quarter of the stillbirths was unexplained. The most frequent maternal pathology was chronic hypertension.
晚期胎儿死亡是一个令人悲痛的事件，尽管在围产期努力实施新的监测方案，但它仍然挑战着我们的临床实践。
研究在10年期间导致晚期妊娠胎儿死亡的主要原因和相关状况的病因学因素。
对一家三级围产期转诊产科在10年期间分娩的208例单胎晚期死产进行回顾性队列分析。系统回顾临床病历、实验室数据和胎儿-胎盘病理检查结果。
晚期胎儿死亡的发生率为每1000例妊娠3.5例。在研究期间，死产发生率没有显著趋势。12例（5.8%）死产发生在产时，72例（35%）为足月妊娠。14%的病例监测不足。诊断时的平均孕周为34周。主要死亡原因是胎儿因素，59例存在该因素，其中25%被认为小于孕周。24.5%的病例死产原因不明。21%的病例发现有母体疾病。高血压疾病很常见，且与孕周早有关（p = 0.028）。
在评估的10年期间，晚期死产发生率没有变化。发生率为3.5‰，与发达国家描述的相同。约四分之一的死产原因不明。最常见的母体病理情况是慢性高血压。
