Clinical management of the induction of labor in intrauterine fetal death: evaluation of incidence of cesarean section and related conditions

Nascimento, Maria Isabel do; Cunha, Alfredo de Almeida; Oliveira, Sandra Regina dos Santos Muri

doi:10.1590/1415-790x201400010016eng

Cited by 8 publications

(7 citation statements)

References 16 publications

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“…This result corresponds to the recommendation of the Brazilian Federation of Associations of Gynecology and Obstetrics and other global organizations, which indicate the route of vaginal delivery as preferential for pregnant women with fetal death [22]. According to the literature, fetal death is not indicative of cesarean section and should be reserved for specific conditions, such as complete-total placenta previa, repeated cesarean sections placenta detachment [23].…”

Section: Discussionsupporting

confidence: 79%

Pregnancies with an outcome of fetal death present higher risk of delays in obstetric care: A case-control study

et al. 2019

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The objective of this study was identify the association between delays in the care provided to pregnant women and the fetal death outcome, in a tertiary reference maternity hospital in the Northeastern Brazil. A case-control study, with 72 cases of fetal death and 144 controls (live births) in women admitted to the Obstetrics Service of the Assis Chateaubriand Teaching Maternity Hospital, in Fortaleza, Ceará. Controls were matched (2:1) by the approximate gestational age of the case. The groups were compared using the three delays model of obstetric care. The Pearson's Chi-square test and the Fisher's exact test were used to compare the groups. P <0.05 was considered statistically significant. The Group with fetal death had a smaller number of prenatal consultations (> 6 consultations: 27.8% in cases, 40.3% in controls, p = 0.003), less risk classification of pregnancy (41.7% vs 55.9%, p = 0.048), less guidance about the health facility for delivery (44.5% vs 64%, p = 0.009), lower frequency of cesarean sections (25.4% vs 65.7%) and higher frequency of hemorrhagic syndromes (33.3% vs 19.4%, p = 0.024) and syphilis (15.3% vs 4.2%, p = 0·004). Variables that persisted significantly associated with fetal death in the logistic regression were: Refusal of assistance (OR = 4.07, IC 95%: 1.08–15.3), Absence or inadequacy of prenatal care (OR = 2.69, IC 95%: 1.07–6.75), Delay in diagnosis (OR = 10.3, IC 95%: 2.58–41.4) and Inadequate patient conduct (OR = 4.88; IC 95%: 1.43–16.6). Despite of having a higher frequency of obstetric complications, gestations with fetal death are more prone to delays in obstetric care.

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Section: Discussionsupporting

confidence: 79%

Pregnancies with an outcome of fetal death present higher risk of delays in obstetric care: A case-control study

et al. 2019

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“…Cesarean delivery risk ranged from 2.4 to 61.8 (incidence range: 33.3-91%) and was the most frequently reported labor and delivery outcome associated with abruption (►Table 1). 2,8,[14][15][16][17][18][19][20][21][22][23][24] The variation in risk estimates is likely attributable to the specification of subpopulations or types of cesarean, as the lowest risk was seen in a cohort study of periviable neonates 14 and the highest risk was seen in nonplanned cesareans among multiparous women. 18 A single study did not find elevated risk of cesarean associated with abruption, but it was limited to deliveries 22 to 26 weeks and the nonabruption cesarean delivery rate was unusually high at 67%.…”

Section: Obstetrical Morbiditymentioning

confidence: 99%

Maternal, Labor, Delivery, and Perinatal Outcomes Associated with Placental Abruption: A Systematic Review

2017

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Objective Risk factors for placental abruption have changed, but there has not been an updated systematic review investigating outcomes. Methods We searched PubMed, EMBASE, Web of Science, SCOPUS, and CINAHL for publications from January 1, 2005 through December 31, 2016. We reviewed English-language publications reporting estimated incidence and/or risk factors for maternal, labor, delivery, and perinatal outcomes associated with abruption. We excluded case studies, conference abstracts, and studies that lacked a referent/comparison group or did not clearly characterize placental abruption. Results A total of 123 studies were included. Abruption was associated with elevated risk of cesarean delivery, postpartum hemorrhage and transfusion, preterm birth, intrauterine growth restriction or low birth weight, perinatal mortality, and cerebral palsy. Additional maternal outcomes included relaparotomy, hysterectomy, sepsis, amniotic fluid embolism, venous thromboembolism, acute kidney injury, and maternal intensive care unit admission. Additional perinatal outcomes included acidosis, encephalopathy, severe respiratory disorders, necrotizing enterocolitis, acute kidney injury, need for resuscitation, chronic lung disease, infant death, and epilepsy. Conclusion Few studies examined outcomes beyond the initial birth period, but there is evidence that both mother and child are at risk of additional adverse outcomes. There was also considerable variation in, or absence of, the reporting of abruption definitions.

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“…This is because all kinds of treatment have some risks to maternal safety, especially when there is an intrauterine fetal loss. 8 For example, thrombogenic substances produced in the placental tissue that enter the maternal circulation increase the risk of disseminated intravascular coagulation. 9 This results in guarded prognosis in those patients managed by observation.…”

Section: Discussionmentioning

confidence: 99%

A retrospective analytical study of caesarean section in intrauterine foetal death cases in a rural medical college

Patra¹,

Chattopadhyay²,

Samanta³

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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Background: Intrauterine fetal death(IUFD) is an unhappy reality, a lamentable incidence for both the family and the caregiver. It is an important indicator of both maternal and perinatal health in a population. The study of fetal death is crucial in promoting actions for maternal and child health. Aim of this study was to determine the incidence, indications and maternal morbidity and maternal mortality associated with caesarean section in patients with IUFD and to establish the place of caesarean section in present day scenario.Methods: The study was a retrospective analysis of all caesarean section carried out in a case of IUFD in last 5 years (2013-2017). The indications, incidence, maternal morbidity, mortality was studied well in this time period in a rural medical college of West Bengal.Results: Total 108425 deliveries occurred in the hospital in last 5 years, out of which 31800 were caesarean section. 56 cases were done in case of diagnosed IUFD. There was 2489 number of IUFDs in the given period. The incidence of IUFD was 22.96 per 1000 deliveries. Induction was done in 2489 cases; 56 cases underwent caesarean section (2.25%) and rest was delivered vaginally.Conclusions: Early diagnosis, early referral and proper antenatal checkup can reduce the chances of IUFD and number of caesarean deliveries in IUFD. The role of cesarean deliveries in previous caesarean deliveries having IUFDs has been emphasized.

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Clinical management of the induction of labor in intrauterine fetal death: evaluation of incidence of cesarean section and related conditions

Cited by 8 publications

References 16 publications

Pregnancies with an outcome of fetal death present higher risk of delays in obstetric care: A case-control study

Pregnancies with an outcome of fetal death present higher risk of delays in obstetric care: A case-control study

Maternal, Labor, Delivery, and Perinatal Outcomes Associated with Placental Abruption: A Systematic Review

A retrospective analytical study of caesarean section in intrauterine foetal death cases in a rural medical college

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