Intrauterine Fetal Demise and Postneonatal Death Stratified by Maternal Education Level and Gestational Age [152]

Background Low birth weight (LBW) is closely related to neonatal morbidity and mortality. Management of LBW infants in developing countries remains limited, due to the low availability of incubators. The Kangaroo Mother Care (KMC) method has been shown to be effective for newborns, especially LBW infants, in which skin-to-skin contact may be conducive for infants’ weight gain, thermoregulation, and heart rate stability.Objective To determine the prognostic factors for KMC success in LBW babies.Methods This cohort study included LBW infants at Dr. Kariadi General Government Hospital, Semarang, by a consecutive sampling method. Success of KMC was assessed by infant weight gain, as well as stabilization of temperature, heart rate, and respiration. Prognostic factors for KMC success that we assessed were birth weight, gestational age, KMC duration, age at KMC onset and maternal education level. Statistical analyses used were Chi-square and relative risk (RR) tests.Results Of 40 LBW infants, 24 were successful in KMC. Birth weight ≥ 1500 grams (RR 0.4; 95%CI 0.23 to 0.73; P=0.001)], gestational age ≥ 34 weeks (RR 0.94; 95%CI 0.46 to 1.89; P=1.00), KMC duration ≥ 65 minutes (RR 1.44; 95%CI 0.76 to 2.75; P= 0.215), high maternal education level (RR 1.25; 95%CI 0.76 to 2.04; P=0.408), and age at KMC onset >10 days (RR 2.69; 95%CI 1.14 to 6.32; P=0.003), were factors that related to the successful of KMC.Conclusion Age at KMC onset > 10 days was a prognostic factor for KMC success in low birth weight babies.

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Intrauterine fetal demise: a retrospective study in tertiary care center in India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20182962 ◽

2018 ◽

Vol 7 (8) ◽

pp. 3069

Author(s):

Anand Karale ◽

Kunaal K. Shinde ◽

Hemant Damle

Keyword(s):

Gestational Age ◽

Maternal Age ◽

Care Center ◽

Tertiary Care ◽

Mode Of Delivery ◽

P Value ◽

Maternal Complications ◽

Fetal Demise ◽

Maternal Risk ◽

Intrauterine Fetal Demise

Background: An Intrauterine Fetal Demise (IUFD) is a major obstetrical catastrophe at any gestational age but the emotional pain and distress caused by this event increases in direct relation to the duration of pregnancy. The objective of the present study was to determine the incidence and possible causes of Intrauterine Fetal Demise (IUFD), and to determine preventive measures.Methods: Retrospective observational study was done from Jan 2015 to Dec 2017 at Smt. Kashibai Navale Medical College and General Hospital, Narhe, Pune. Inclusion criteria were all the pregnant women with IUFD delivered at the centre, at or above 24 weeks of gestation. The methodology followed were parameters of assessment for analysis were maternal age, parity, probable causes for IUFD, booked or unbooked cases, mode of delivery, maternal complications, and placental histopathology. Statistical data were analyzed using SPSS version 25.Results: The incidence of IUFD at authors’ hospital was 27/1000 live births. The IUFD rate was similar in maternal age <20years and >30years (p value 0.26). The incidence of IUFD increased with decreasing gestational age which was statistically significant (p value 0.001). IUFD incidence was higher in multiparous women compared to primiparous women (p value 0.036 with OR of 1.6 and 95% CI 1.02 to 2.54). The rate of IUFD was similar when sex of the baby was analyzed. 49.4% of fetuses had signs of maceration. The major cause of IUFD was severe preeclampsia (48.1%) which included HELLP syndrome, IUGR, Abruption. Maternal anemia (20.4%), GDM (3.8%), SLE (2.5%), APLA positive (2.5%), anhydramnios (6.3%) were some of the other important causes of IUFD.Conclusions: This study was conducted to determine the incidence of IUFD and associated maternal risk factors. By understanding the contributing factors, we can seek ways of avoiding recurrence of IUFD by proper antenatal care and early diagnosis of obstetric complications and its appropriate management.

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580: A race-stratified analysis of the risk of intrauterine fetal demise within small for gestational age deliveries

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2011.10.598 ◽

2012 ◽

Vol 206 (1) ◽

pp. S264

Author(s):

Jonathan M. Snowden ◽

Yvonne W. Cheng ◽

Amy E. Doss ◽

Rachel Pilliod ◽

Aaron B. Caughey

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Fetal Demise ◽

Intrauterine Fetal Demise ◽

Stratified Analysis

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Obstetric outcome in twin pregnancies complicated with single intrauterine fetal demise

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20202747 ◽

2020 ◽

Vol 9 (7) ◽

pp. 2998

Author(s):

Priyanka Chaudhari ◽

Vinita Gupta ◽

Anshu Sharma ◽

Archna Tandon ◽

Namrata Saxena ◽

...

Keyword(s):

Gestational Age ◽

Mode Of Delivery ◽

Intrauterine Fetal Death ◽

Fetal Mortality ◽

Delivery Mode ◽

Fetal Demise ◽

Maternal Risk ◽

Monochorionic Twin ◽

Intrauterine Fetal Demise ◽

Twin Pregnancies

Background: It has been reported that single intrauterine fetal death in twin pregnancy occurs in 3.7-6.8% all twin pregnancies. The objective of this study was to evaluate the maternal and fetal demographic features and feto-maternal outcomes in twin pregnancies complicated with single intrauterine fetal demise and evaluation of available management guidelines.Methods: This retrospective study was conducted at obstetrics and gynecology department of SGRRIM and HS, Dehradun, Uttarakhand between January 2015 and December 2019. There was a total of 182 twin deliveries at study hospital during this period and 35 of these cases were complicated with single intrauterine fetal demise. Maternal age, parity, chorionicity of twin gestation, gestational age at single intrauterine fetal demise, gestational age at delivery, mode of delivery, birth weight, Apgar Score at birth, neonatal intensive care unit stay of newborn, maternal fibrinogen levels during pregnancy and delivery time and associated obstetric complications were analyzed in these cases of single intrauterine fetal demise with twin gestation. All monochorionic twin pregnancies were included in the study Group A and dichorionic twin in Group B.Results: The mean age of 32 patients included in study was 29.7±4.6 years. Twenty (62.5%) of these patients were dichorionic and 12 (37.5%) of these were monochorionic twin gestation. Single intrauterine fetal demise occurred in first trimester in 8 (25%) patients, during the second trimester 20 (62.5%) and 4 (12.5%) patients had third trimester single intrauterine fetal demise. Preterm deliveries occurred in 18 (56.3%) of patients and 8 (44.4%) of patients were of monochorionic and 10 (55.6%) of dichorionic twin patients. Among thirty-two patients, 11 (34.4%) patients had caesarean delivery and 21 (65.6%) patient had vaginal birth. No maternal or fetal mortality noted and none of the patients had maternal coagulation disorder.Conclusions: This study indicates that in cases of twin pregnancies with single fetal intrauterine demise with individualized management plan at higher centre and close maternal and fetal surveillance live fetus can be saved without any maternal risk.

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Nonimmune hydrops fetalis with intrauterine fetal demise presenting at 41-weeks gestational age: the ultrasonographic findings and case report

Journal of Clinical Case Reports and Studies ◽

10.31579/2690-8808/062 ◽

2021 ◽

Vol 2 (1) ◽

pp. 01-04

Author(s):

Sule MB ◽

Umar AU ◽

Umar FK ◽

Yunusa M ◽

Sani MT ◽

...

Keyword(s):

Gestational Age ◽

Abdominal Cavity ◽

Hydrops Fetalis ◽

Laboratory Evaluation ◽

Skin Thickness ◽

Fetal Demise ◽

Intrauterine Fetal Demise ◽

Abnormal Accumulation ◽

Obstetric Ultrasonography ◽

The Right

Hydrops fetalis is the abnormal accumulation of fluid in two or more different fetal compartments and most times associated with polyhydramnios and placental edema, and has an estimated incidence of about 1 in 3000 pregnancies. A 27-year-old multigravida; G8P7, was referred for the first ultrasonography in the Index pregnancy on account of not feeling/observing fetal movement for about two-weeks. The obstetric ultrasonography demonstrated a single fetus with absent fetal heartbeat, in hyper-flexed position, accumulation of fluid in the abdominal cavity; right sub-diaphragmatic region and in the right pleural cavity in keeping with fetal ascites and fetal effusion. There is overriding of fetal skull with Thickened/edematous placenta with a thickness of about 7cm, and fetal skin thickness of about 10mm. There is associated intrafetal gas. The estimated femoral length gave a gestational age approximating 41-weeks. A diagnosis of hydrops fetalis most likely non-immune form with fetal demise presenting at 41-weeks gestational age in a multiparous woman with features anemia presumably from sepsis and urinary tract infection (bilateral pyelonephritis and cystitis) in a setting of poor antenatal care was entertained. The fetus was expelled following induction of labor at the peripheral centre, the patient had transfusion done with commencement of antibiotics for correction of anemia and sepsis with plans of further clinical and laboratory evaluation. We present the ultrasonographic features of hydrops fetalis with intrauterine fetal demise due to its unique presentation

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164: Risk of intrauterine fetal demise and postfetal death in women of advanced maternal age stratified by gestational age at delivery

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2009.10.179 ◽

2009 ◽

Vol 201 (6) ◽

pp. S74

Author(s):

Melissa G. Rosenstein ◽

Clara Ward ◽

Yvonne W. Cheng ◽

James Nicholson ◽

Aaron B. Caughey

Keyword(s):

Gestational Age ◽

Maternal Age ◽

Advanced Maternal Age ◽

Fetal Demise ◽

Intrauterine Fetal Demise ◽

Gestational Age At Delivery

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Prevalence of Language Delay among Healthy Preterm Children, Language Outcomes and Predictive Factors

Children ◽

10.3390/children8040282 ◽

2021 ◽

Vol 8 (4) ◽

pp. 282

Author(s):

Miguel Pérez-Pereira

Keyword(s):

Gestational Age ◽

Language Impairment ◽

Maternal Education ◽

Longitudinal Design ◽

Age Groups ◽

Full Term ◽

Language Delay ◽

Preterm Children ◽

General Terms ◽

Extremely Preterm

Language delay (LD) and its relationship with later language impairment in preterm children is a topic of major concern. Previous studies comparing LD in preterm (PT) and full-term (FT) children were mainly carried out with samples of extremely preterm and very preterm children (sometimes with additional medical problems). Very few of them were longitudinal studies, which is essential to understand developmental relationships between LD and later language impairment. In this study, we compare the prevalence of LD in low-risk preterm children to that of FT children in a longitudinal design ranging from 10 to 60 months of age. We also analyze which variables are related to a higher risk of LD at 22, 30 and 60 months of age. Different language tests were administered to three groups of preterm children of different gestational ages and to one group of full-term children from the ages of 10 to 60 months. ANOVA comparisons between groups and logistic regression analyses to identify possible predictors of language delay at 22, 30 and 60 months of age were performed. The results found indicate that there were practically no differences between gestational age groups. Healthy PT children, therefore, do not have, in general terms, a higher risk of language delay than FT children. Previous language delay and cognitive delay are the strongest and longest-lasting predictors of later language impairment. Other factors, such as a scarce use of gestures at 10 months or male gender, affect early LD at 22 months of age, although their effect disappears as children grow older. Low maternal education appears to have a late effect. Gestational age does not have any significant effect on the appearance of LD.

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Florid Bacillus cereus Infection of the Placenta Associated With Intrauterine Fetal Demise

Pediatric and Developmental Pathology ◽

10.1177/1093526621999026 ◽

2021 ◽

pp. 109352662199902

Author(s):

Stephanie Shea ◽

Alberto Paniz-Mondolfi ◽

Emilia Sordillo ◽

Michael Nowak ◽

Fumiko Dekio

Keyword(s):

Bacillus Cereus ◽

Placental Tissue ◽

Maternal Blood ◽

Gastrointestinal Infections ◽

Gram Positive ◽

Fetal Demise ◽

Placental Infection ◽

Intrauterine Fetal Demise ◽

Acute Necrotizing ◽

Poor Outcomes

Bacillus cereus is a gram-positive, rod-shaped bacterium that is commonly implicated in foodborne illness but has also become increasingly recognized as a source of serious non-gastrointestinal infections, including sepsis, meningitis, and pneumonia. Non-gastrointestinal B. cereus infections have been identified in children, especially in neonates; however, there are no previously described cases of fetal demise associated with B. cereus placental infection. We present a case of acute chorioamnionitis-related intrauterine fetal demise of twin A at 17 weeks gestation, noted two days after selective termination of twin B. Histological examination revealed numerous gram-positive bacilli in placental tissue, as well as fetal vasculature, in the setting of severe acute necrotizing chorioamnionitis and subchorionitis, intervillous abscesses, acute villitis, and peripheral acute funisitis. Cultures of maternal blood and placental tissue both yielded growth of B. cereus. This case underscores the importance of B. cereus as a human pathogen, and specifically demonstrates its potential as an agent of severe intraamniotic and placental infection with poor outcomes for the fetus.

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