Assessment of "fresh" versus "macerated" as accurate markers of time since intrauterine fetal demise in low-income countries.

Autor: Gold KJ; Department of Family Medicine, University of Michigan, Ann Arbor, USA; Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, USA. Electronic address: ktgold@umich.edu., Abdul-Mumin AR; Department of Obstetrics and Gynaecology, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Komfo Anokye Teaching Hospital, Kumasi, Ghana., Boggs ME; Department of Family Medicine, University of Michigan, Ann Arbor, USA., Opare-Addo HS; Department of Obstetrics and Gynaecology, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Komfo Anokye Teaching Hospital, Kumasi, Ghana., Lieberman RW; Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, USA; Department of Pathology, University of Michigan, Ann Arbor, USA.
Jazyk: angličtina
Zdroj: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [Int J Gynaecol Obstet] 2014 Jun; Vol. 125 (3), pp. 223-7. Date of Electronic Publication: 2014 Mar 04.
DOI: 10.1016/j.ijgo.2013.12.006
Abstrakt: Objective: To compare provider assessment of fetal maceration with death-to-delivery interval to evaluate the reliability of appearance as a proxy for time of death.
Methods: Cohort chart abstraction was performed for all stillbirth deliveries at or above 28 weeks of gestation during a 1-year period in a teaching hospital in Ghana.
Results: Of 470 stillborn infants, 337 had adequate data for analysis. Of 47 fetuses alive on admission with death-to-delivery intervals estimated to be less than 8 hours (expected to be reported as fresh), 14 (30%) were actually reported as macerated. Of 94 cases in which the fetus was deceased on admission with death-to-delivery interval of more than 8 hours (expected to be macerated), 17 (18%) were described as fresh.
Conclusion: Provider description of fetal appearance may be an unreliable indicator for time since fetal death. The findings have significant implications for stillbirth prevention and assessment.
(Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.)
Databáze: MEDLINE
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