Clinical characteristics and etiological analysis of late fetal death

Abstract

With the continuous improvement of obstetric quality, the death of the fetus caused by serious pregnancy complications showed a downward trend. However, the etiological analysis of late fetal death is still an urgent health problem and early detection is required to reduce the risk of stillbirth. This study aimed to investigate the clinical and pathological features of late fetal death, and to propose the intervention measures to reduce the incidence of perinatal mortality. This was a retrospective analysis with 131 cases of fetal death of more than 28 gestation weeks from February 2009 to December 2015 in International Peace Maternity and Child-health Hospital. The related factors of maternal and umbilical cord were analyzed by STATA software. Among the 131 cases of dead fetuses in the late stage, 71 (54.2%) cases died of umbilical cord factor. Maternal age of late fetal death usually occurred from 25~35 years (83.97%). History of hysteromyoma, syphilis, thyroid disease, diabetes or uterine abnormalities of pregnant women are risk factors contributed to fetal death. Most pregnant women had regular prenatal examination 107 (89.9%), among which the number of stillbirths with ultrasound screening abnormalities was 69 (58.0%), 47 (39.5%) cases with D-Dimer abnormal of blood coagulation function, and 32 (26.9%) cases with positive bacterial culture results of fetal death. There were no statistically significant differences in fetal death rate between fasting blood glucose, platelet counts, ultrasound of fetal biparietal diameter, and pregnancy age, with or without abortion history (all p > 0.05). Umbilical cord torsion, edema, necrosis, and funisitis were the most common factors associated with late fetal death. In conclusion, perinatal healthcare management and monitoring should be strengthened, and the umbilical cord length, diameter, spiral coil index, blood flow, with or without torsion, and other conditions should be classified as routine examination of fetal structural screening in the second trimester ultrasound.