Birth - Stillbirth and Perinatal Death: Difference between revisions
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Revision as of 09:49, 13 September 2016
Embryology - 15 Jun 2024 Expand to Translate |
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Introduction
The perinatal period is the early postnatal period relating to the birth, statistically it includes the period up to 7 days after birth. Neonatal period is the four weeks/month after birth. Stillbirth and perinatal death can be classified by a number of different systems, all still have "unexplained" or "other" as a potential option. in several systems contribute to many of these deaths. Neonatal deaths include a broader age range of infants who have also died after birth from various causes.
Stillbirths with a gestational age of 28 weeks or more are defined as "late fetal deaths".
There are several death classification systems used in different countries around the world, the most recent are the suggested ReCoDe (UK, 2005), the modified Whitfield (Australia/New Zealand, 2004), and the World Health Organization's International Classification of Disease (ICD-10) systems.
A common stillbirth classification is still "unexplained", with recent analysis of data showing fetal growth restriction is a common antecedent.
Australian Categories of Perinatal and Infant Death[2] |
Some Recent Findings
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More recent papers |
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This table allows an automated computer search of the external PubMed database using the listed "Search term" text link.
More? References | Discussion Page | Journal Searches | 2019 References | 2020 References Search term: Stillbirth <pubmed limit=5>Stillbirth</pubmed> Search term: Perinatal Death <pubmed limit=5>Perinatal Death</pubmed> |
World High Rate Countries
Graph shows the number of infant deaths / 1,000 live births for countries above 1%.
Classification Differences
- World Health Organization - report stillbirths weighing 500g, or born at or after 22 weeks gestational age GA, or 25 cm crown-heel length (CRL), if neither birthweight nor gestational age is known. Restrict stillbirth used for international reporting to those weighing 1,000g (or born at or after 28 weeks gestational age or 35 cm CRL.
- Australia - a baby who is stillborn must be of at least 20 weeks gestational age or weigh 400g or more.
- New Zealand - include all fetal deaths from 20 week gestational age or 400g birthweight[10].
- Canada - includes fetal deaths from 20 week gestational age or 500g birthweight in all provinces except Quebec where only the birthweight criterion applies. [11]
- United States - states to report fetal deaths of 20 or more weeks gestation, but the definition of a ‘fetal death’ specifically excludes deaths that result from induced termination of pregnancy.[12]
- United Kingdom - 24 weeks gestational age and includes all fetal deaths that meet this criterion.
- Europe - the lower limit ranges from 16–26 weeks gestational age and member states vary in their capacity to include late termination of pregnancy that meet their gestation criterion for a stillbirth (Gissler 2012).
Decreased Fetal Movements
Decreased fetal movements (DFM) can occur during the normal fetal period. Pregnancies with multiple occasions of decreased fetal movements are at increased risk of poor perinatal outcomes, including fetal death, intrauterine fetal growth restriction (IUFGR) or preterm birth. An evaluation of women presenting with DFM should involve a thorough history, examination and auscultation of fetal heart, cardiotocography (CTG) and ultrasound if indicated. There are guidelines and position statements available for DFM.
There have been studies using maternal recording of movements, that have limitations of non-compliance and initial analysis shows poor correlation.[9]
A population-based study has also been unable to link, except for some subgroups, maternally perceived DFM to placental pathology.[13]
- Links: Fetal Development | Ultrasound | Australia RANZCOG Guideline 2013 PDF | Health 2011 | UK 2011 Guideline No. 57 | USA Reduced fetal movements 2011
Australian Data
Australian Perinatal Deaths | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|
Year | 2000 | 2001 | 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 |
Rate | 10.1 | 10.4 | 9.8 | 9.8 | 9.9 | 10.6 | 9.2 | 8.8 | 8.4 | 9.0 |
Number | 2,534 | 2,571 | 2,475 | 2,480 | 2,541 | 2,769 | 2,459 | 2,532 | 2,501 | 2,671 |
- Perinatal deaths are all fetal deaths (at least 20 weeks gestation or at least 400 grams birth weight) plus all neonatal deaths (death of a live born baby within 28 completed days of birth).
- Perinatal death rates are calculated per 1,000 all births for the calendar year.
- Source: ABS Births, Australia, 2009 (cat. no. 3301.0); ABS Perinatal Deaths, Australia, 2009 (cat. no. 3304.0).
NSW
In New South Wales (2002) 613 perinatal deaths were reported.
- Unexplained antepartum deaths: 26.3% of perinatal deaths (or 39.2% of stillbirths)
- Spontaneous preterm labour: 20.6% (less than 37 weeks gestation)
- Congenital abnormality: 16.8%
- Antepartum haemorrhage: 8.5%
- Specific perinatal conditions: 7.3%, of which twin-twin transfusion accounted for 2.3% of deaths
- Hypertension (high blood pressure): 5.5%
- Perinatal infection: 4.4%
- Maternal disease: 4.4%
- Hypoxic peripartum death: 3.8%
Neonatal deaths (four weeks/month after birth)
- extreme prematurity was most common cause (39.6%)
- congenital abnormality (19.3%)
- neurological disease (13.4%)
- cardio-respiratory conditions (11.9%)
- infection (8.4%)
Data: Report of the New South Wales Chief Health Officer, 2004 accessed 19Oct05
USA Data
Leading causes of infant death for 2005:[14]
- Congenital malformations, deformations and chromosomal abnormalities
- Disorders related to short gestation and low birthweight, not elsewhere classified
- Sudden infant death syndrome
- Newborn affected by maternal complications of pregnancy
- Newborn affected by complications of placenta, cord and membranes
- Accidents (unintentional injuries); Respiratory distress of newborn
- Bacterial sepsis of newborn
- Neonatal hemorrhage
- Necrotizing enterocolitis of newborn.
Fetal Death Information
- 2003 Revisions of the U.S. Standard Certificates of Live Birth and Death and the Fetal Death Report. The revision process is generally carried out every 10 to 15 years.
- Maternal, Paternal and medical and health information is collected.
CAUSE/CONDITIONS CONTRIBUTING TO FETAL DEATH
- INITIATING CAUSE/CONDITION
- OTHER SIGNIFICANT CAUSES OR CONDITIONS
- WEIGHT OF FETUS (grams preferred, specify unit)
- ESTIMATED TIME OF FETAL DEATH
- WAS AN AUTOPSY PERFORMED?
- WAS A HISTOLOGICAL PLACENTAL EXAMINATION PERFORMED?
- WERE AUTOPSY OR HISTOLOGICAL PLACENTAL EXAMINATION RESULTS USED IN DETERMINING THE CAUSE OF FETAL DEATH?
Links: 2003 Revisions of the U.S. Standard Certificates of Live Birth and Death and the Fetal Death Report
Conditions Associated with Stillbirth
Based upon the 2007 National Institute of Child Health and Human Development workshop. [9]
Infection
- Severe maternal illness
- Placental infection leading to hypoxemia
- Fetal infection leading to congenital deformity
- Fetal infection leading damage of a vital organ
- Precipitating preterm labor with the fetus dying in labor
Maternal medical conditions
- Hypertensive disorders
- Diabetes mellitus
- Thyroid disease
- Renal disease
- Liver disease
- Connective tissue disease (systemic lupus erythematosus)
- Cholestasis
Other
- Antiphospholipid syndrome
- Heritable thrombophilias
- Red cell alloimmunization
- Platelet alloimmunization
- Congenital anomaly and malformations
- Chromosomal abnormalities including confined placental mosaicism
- Fetomaternal hemorrhage
- Fetal growth restriction
- Placental abnormalities including vasa previa and placental abruption
- Umbilical cord pathology including velamentous insertion, prolapse, occlusion and entanglement
- Multifetal gestation including twin–twin transfusion syndrome and twin reverse arterial perfusion
- Amniotic band sequence
- Central nervous system lesions
References
- ↑ <pubmed>17411312</pubmed>| PLoS
- ↑ 2.0 2.1 AIHW: Hilder L, Li Z, Zeki R & Sullivan EA 2014. Stillbirths in Australia 1991-2009. Perinatal statistics series no. 29. Cat. no. PER 63. Canberra: AIHW.
- ↑ <pubmed>25901868</pubmed>
- ↑ <pubmed>24044524</pubmed>
- ↑ <pubmed>21918640</pubmed>| PLoS Med.
- ↑ <pubmed>21501437</pubmed>
- ↑ <pubmed>20634347</pubmed>
- ↑ <pubmed>11739216</pubmed>
- ↑ 9.0 9.1 9.2 <pubmed>19888051</pubmed> Cite error: Invalid
<ref>
tag; name 'PMID19888051' defined multiple times with different content - ↑ Perinatal and Maternal Mortality Review Committee (PMMRC). 2013. Seventh Annual Report of the Perinatal and Maternal Mortality Review Committee: Reporting mortality 2011. Wellington: Health Quality & Safety Commission
- ↑ Public Health Agency of Canada (PHAC). 2008. Canadian Perinatal Health Report, 2008 Edition. Ottawa.
- ↑ Kowaleski J. 1997. State definitions and reporting requirements for live births, fetal deaths, and induced terminations of pregnancy (1997 revision). Hyattsville, Maryland: National Center for Health Statistics.
- ↑ <pubmed>22723978</pubmed>
- ↑ <pubmed>20361522</pubmed>
Reviews
Articles
Search PubMed
July 2010 "Perinatal Death" All (8144) Review (899) Free Full Text (1129)
Search Pubmed: Stillbirth | Perinatal Death
External Links
External Links Notice - The dynamic nature of the internet may mean that some of these listed links may no longer function. If the link no longer works search the web with the link text or name. Links to any external commercial sites are provided for information purposes only and should never be considered an endorsement. UNSW Embryology is provided as an educational resource with no clinical information or commercial affiliation.
- Stillbirth Foundation Australia
- New York Times Breaking the Silence of Stillbirth 10 Feb 2013
Glossary Links
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Cite this page: Hill, M.A. (2024, June 15) Embryology Birth - Stillbirth and Perinatal Death. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Birth_-_Stillbirth_and_Perinatal_Death
- © Dr Mark Hill 2024, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G