Dimitrov G, Frandeva B, Garnizov T, Zlatkov V, Dimitrov A
Akush Ginekol (Sofiia). 2014;53(3):3-7.
Stillbirths represent 50% of all perinatal mortality and remain significant and unanswered problem.
To investigate the causes of stillbirths in term and preterm fetuses and place of intrauterine growth retardation in the pathogenesis of antenatal death.
The study was retrospective for the period 2008 to 2013, covers 217 cases of stillbirths in University Hospital "Maichin dom" Sofia. Gestational age was from 23 to 41 weeks. Inclusion criteria for the study were: antenatal occurred dead and singleton pregnancy. Exclusion criteria: fetal malformations and multiple pregnancies. Thus number of enrolled cases was 153.
The causes of stillbirths are different in different groups according gestational age. The cases of unknown cause, abruption of placenta and preeclampsia prevail in preterm group. The term stillborns headed with pathology of the umbilical cord, followed by cases of unknown cause, diabetes and infection. Overall, preterm group stillborn with mass below 10 percentile for the gestational age - 53 % predominate, compared with those born at term - 39%.
The incidence of stillbirths is higher in preterm than term born fetuses. The causes of antenatal death in preterm is mainly abruption of placenta and preeclampsia, whereas in term - pathology of the umbilical cord. In premature stillborn intrauterine growth retardation is more common in comparison with those on term. Unexplained antenatal fetal death is more common in preterm fetuses.
死产占围产期死亡总数的50%,仍然是一个重大且未得到解决的问题。
调查足月和早产胎儿死产的原因以及宫内生长受限在产前死亡发病机制中的地位。
该研究为回顾性研究,时间跨度为2008年至2013年,涵盖索菲亚“麦金多姆”大学医院的217例死产病例。孕周为23至41周。该研究的纳入标准为:产前死亡且为单胎妊娠。排除标准:胎儿畸形和多胎妊娠。因此,纳入病例数为153例。
根据孕周不同,不同组别的死产原因有所不同。早产组中原因不明、胎盘早剥和先兆子痫的病例占主导。足月死产中脐带病变最为常见,其次是原因不明的病例、糖尿病和感染。总体而言,早产组中出生体重低于孕周第10百分位数的死产儿占53%,高于足月出生的死产儿(占39%)。
早产胎儿的死产发生率高于足月出生的胎儿。早产产前死亡的主要原因是胎盘早剥和先兆子痫,而足月则是脐带病变。与足月死产儿相比,早产死产儿中宫内生长受限更为常见。原因不明的产前胎儿死亡在早产胎儿中更为常见。