Management of stillbirth delivery

Chakhtoura, Nahida; Reddy, Uma M.

doi:10.1053/j.semperi.2015.07.016

Cited by 18 publications

(16 citation statements)

References 22 publications

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“…Women with a history of preterm delivery may be at increased risk of CKD and ESRD, 17 , 19 , 29 , 35 and this may potentially confound the association between stillbirth and maternal renal disease. However, stillbirth often results in a preterm delivery, 36 and thus, preterm birth may also mediate the association with maternal CKD/ESRD. Controlling for an intermediate variable would introduce over-adjustment bias, 37 thus we did not control for preterm delivery in our analysis.…”

Section: Discussionmentioning

confidence: 99%

Stillbirth is associated with increased risk of long-term maternal renal disease: a nationwide cohort study

Barrett

McCarthy

Evans

et al. 2020

American Journal of Obstetrics and Gynecology

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Background Stillbirth is a devastating adverse pregnancy outcome that may occur without any obvious reason or may occur in the context of fetal growth restriction, preeclampsia, or other obstetric complications. There is increasing evidence that women who experience stillbirths are at greater risk of long-term cardiovascular disease, but little is known about their risk of chronic kidney disease and end-stage renal disease. We conducted the largest study to date to investigate the subsequent risk of maternal chronic kidney disease and end-stage renal disease following stillbirth. Objective To identify whether pregnancy complicated by stillbirth is associated with subsequent risk of maternal chronic kidney disease and end-stage renal disease, independent of underlying medical or obstetric comorbidities. Study Design/Methods We conducted a population-based cohort study using nationwide data from the Swedish Medical Birth Register, National Patient Register, and Swedish Renal Register. We included all women who had live births and stillbirths from 1973 to 2012, with follow-up to 2013. Women with preexisting renal disease were excluded. Cox proportional hazard regression models were used to estimate adjusted hazard ratios and 95% confidence intervals for associations between stillbirth and maternal chronic kidney disease and end-stage renal disease respectively. We controlled for maternal age, year of delivery, country of origin, parity, body mass index, smoking, gestational diabetes, preeclampsia, and small for gestational age deliveries. Women who had a history of medical comorbidities, which may predispose to renal disease (prepregnancy cardiovascular disease, hypertension, diabetes, lupus, systemic sclerosis, hemoglobinopathy, or coagulopathy), were excluded from the main analysis and examined separately. Results There were 1,941,057 unique women who had 3,755,444 singleton pregnancies, followed up over 42,313,758 person-years. The median follow-up time was 20.7 years (interquartile range, 9.9–30.0 years). 13,032 women (0.7%) had at least 1 stillbirth. Women who had experienced at least 1 stillbirth had a greater risk of developing chronic kidney disease (adjusted hazard ratio, 1.26; 95% confidence interval, 1.09–1.45) and end-stage renal disease (adjusted hazard ratio, 2.25; 95% confidence interval, 1.55–3.25) compared with women who only had live births. These associations persisted after removing all stillbirths that occurred in the context of preeclampsia, and small for gestational age or congenital malformations (for chronic kidney disease, adjusted hazard ratio, 1.33; 95% confidence interval, 1.13–1.57; for end-stage renal disease, adjusted hazard ratio, 2.95; 95% confidence interval, CI 1.86–4.68). There was no significant association observed between stillbirth and either chronic kidney disease or end-stage renal disease in women who had preexisting medical comorbidities (chronic kidney disease, adjust...

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Section: Discussionmentioning

confidence: 99%

Stillbirth is associated with increased risk of long-term maternal renal disease: a nationwide cohort study

Barrett

McCarthy

Evans

et al. 2020

American Journal of Obstetrics and Gynecology

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“…Obstetric conditions such as abruptio placenta, placenta previa totalis, fetal presentation, cephalopelvic examination, and history of uterine scar were the main determinants of the management. Some authors depicted that the labor would start spontaneously within 1-2 weeks after the death of the fetus, yet we did not consider expectant management in any of our patients [11,17]. Women were at risk of coagulopathy abnormalities unless the delivery occurred within 3-4 weeks after fetal demise [8,18].…”

Section: Discussionmentioning

confidence: 94%

“…Our study revealed that abruptio placenta was the most crucial cause of stillbirth, like those in the literature. Abruptio placenta not only causes stillbirth but also maternal adverse outcomes such as uterine atony, peripartum hysterectomy, and DIC, especially in delayed cases [8,17,26,27]. Approximately half of the placenta abruptio cases could not be detected by ultrasound, especially acute abruption [28].…”

Section: Discussionmentioning

confidence: 99%

The risk factors and maternal adverse outcomes of stillbirth

Şimşek¹,

Demirci²,

Çakmak³

2021

Journal of Surgery and Medicine

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“…Porém nesse estudo, aproximadamente 38% dos partos foram cesarianas representando um índice alto quando comparado ao estudo de Boyle et al 25 que, dentre 611 casos de OFIU, apenas 93 (15,2%) mulheres foram submetidas à cesariana, sendo que 43,0% (46) delas tinham histórico deste tipo de parto anterior. Além disso, no presente estudo, 32,6% das mulheres submetidas a cesariana eram nulíparas e não foram encontradas justificativas para a indicação do parto cirúrgico no prontuário.…”

Section: Conclusõesunclassified

Análise Dos Fatores Associados Ao Óbito Fetal Intrauterino Nos Casos Atendidos Em Um Hospital Público

et al. 2019

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O objetivo dessa pesquisa foi identificar e analisar os fatores associados aos óbitos fetais intrauterinos a partir dos registros nos prontuários médicos, de um hospital público da região metropolitana de São Paulo, no período de 2010 a 2015. Método: Realizou-se estudo exploratório descritivo e retrospectivo. Resultados: A análise de prontuários permitiu identificar que a idade gestacional, quando da ocorrência do óbito fetal, majoritariamente estava entre 28 e 37 semanas, o peso da maioria dos bebês estava acima de 2000g e as patologias predominantes foram as síndromes hipertensivas. Conclusões: Dada a possibilidade de identificação precoce e monitoramento de tais patologias pela atenção básica na assistência ao pré-natal, concluiu-se que é fundamental investir nestes serviços, com vistas à prevenção do óbito fetal, bem como na melhoria dos registros nos prontuários e na implementação de ações de vigilância do óbito fetal.

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Management of stillbirth delivery

Cited by 18 publications

References 22 publications

Stillbirth is associated with increased risk of long-term maternal renal disease: a nationwide cohort study

Stillbirth is associated with increased risk of long-term maternal renal disease: a nationwide cohort study

The risk factors and maternal adverse outcomes of stillbirth

Análise Dos Fatores Associados Ao Óbito Fetal Intrauterino Nos Casos Atendidos Em Um Hospital Público

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