Intrauterine infection within the causes of perinatal mortality

Abstract

Introduction . Intrauterine infections are of particular importance to perinatal mortality as they are preventable causes. This is meant to be the base to create efficient medical and preventive interventions to reduce perinatal losses. Aim. This study was conducted to assess a share of intrauterine infections in the structure of causes of perinatal deaths. Materials and methods. 62 autopsy reports were analyzed using materials of the pathology department of Khabarovsk Kray Perinatal Center as of 2018, including 35 cases of antenatal fetal death in inevitable miscarriage, 11 cases of induced medical abortions, and 9 cases of intranatal fetal death. In addition, 7 death cases of newborns who died in the early neonatal period were studied. Postmortem examination was performed to the accepted standards, including morphological analysis of autopsy material. Results . Respiratory disorders come first as the cause of stillbirths (90.9% of cases). Congenital anomalies of internal organs, placenta, membranes and umbilical cord rank second (56.4% of cases). Infectious inflammation of secundines were found in 54.5% of cases. Immediate cause of death in the early neonatal period was found to be respiratory disorders resulting from prior disease or concurrent diseases (anomalies of internal organs, congenital infection, and hemolytic disease of newborns). In all cases of early perinatal death, an infectious condition was identified as primary, concurrent (28.5% - 2 cases out of 7) or background disease (100% of secundines infection). Conclusion . Congenital infections have been found to be a significant factor in perinatal mortality. Thorough analysis of causes of death, better etiologic verification of congenital infections and morphological diagnosis of autopsy material will enable to assess a risk of recurrent fetal and neonatal loss in subsequent pregnancies, and contribute to the improvement of medical and preventive interventions.