Perinatal Mortality: Changes in the Diagnostic Panorama 1974–1980

Abstract

During the period 1974-1980, all late abortions (greater than 19 completed gestational weeks) (LA), late fetal deaths (LFD) and early neonatal deaths (END) were surveyed in a continuous material of 17813 births with an ascertained gestational age established by early ultrasound fetometry. There was no maternal death during the period. The total perinatal mortality (PM) was 0.98% with an END rate of 0.51%. In about 45% of LFD no diagnosis was found. Intrapartum death was extremely rare as was END caused by asphyxia or infection. In END, death from immaturity constituted the major group in the beginning of the period, while after 1977 lethal malformations was the dominating diagnosis. There was a continuous decrease in Idiopathic Respiratory Distress Syndrome (IRDS) as a cause of END. The proportion of END in extremely premature children showed a constant decrease in the beginning of the period. No difference in sex was found in END except for lethal malformations where there was a significant male preponderance. As a consequence of a more active obstetrical care, some fetuses who would previously have been classified as LA were probably delivered liveborn, extremely premature and appeared as END. The question of where to set the limits for what should be included in PM is thus highly relevant.

Epidemiology of intrauterine fetal death in Dhaka National Medical College Hospital

“…e incidence of stillbirth reported from western countries ranges from 4.7% to 12.0%. [4][5][6][7][8][9][10] is is lower than that observed in our study. e reason could be a high number of unsupervised deliveries due to various reason like literacy, low socioeconomic status and the paucity of monitoring facilities in rural areas.…”

Sex and gender differences in newborn infants: why are boys at increased risk?

“…The newborn male disadvantage is a well-established fact [1][2][3]. Little is known about possible mechanisms contributing to the increased morbidity and mortality in newborn boys.…”

Mortalidade perinatal e neonatal no Hospital de Clínicas de Porto Alegre

“…As infecções pós-natais ou hospitalares passaram a ser a terceira causa de morte no período B, devido a maior sobrevida dos prematuros e maior vigilância no registro de infecções hospitalares 3 . As malformações graves tornaram-se a primeira causa de morte, à semelhança dos hospitais 7,16,17 em que nem sempre o fator prematuridade está presente. Essas doenças indicam aumento na transferência de gravidezes de risco para os hospitais terciários.…”

“…Os dados de Toronto (80-84), Quebec (80-82) e Carolina do Norte (80-84) mostraram as malformações fatais e prematuridade extrema como as principais causas. Essas duas enfermidades são consideradas, usualmente, como patologias não-preveníveis, e as demais refletem deficiên-cias de assistência médica no pré-natal e no parto das gestantes e no recém-nascido, o mau atendimento na sala de parto e na terapia intensiva neonatal 5,11,[14][15][16][17] . A análise dos natimortos mostrou como primeira causa a asfixia perinatal, em geral, representando as dificuldades de assistência ao parto, pois nem sempre é detectada.…”