Can anything be done about mid-trimester fetal wastage?
In Victoria in the triennium 1982-1984, perinatal losses between 22 and 28 weeks' gestation accounted for 32% of the overall perinatal wastage of 12.7 per 1,000 births. Over the same period only 1.2% of babies were delivered weighing less than 1,500g, but this group made up 40% of the total stillbirths and 50% of the neonatal deaths. By contrast the perinatal wastage was only 7 per 1,000 births in babies born weighing more than 1,500g and this included lethal congenital malformations. The major antenatal risk factors contributing to the high mid-trimester fetal wastage were premature labour (17.7%), multiple pregnancy (13.9%), cervical incompetence (12.9%), antepartum haemorrhage (12.9%), premature rupture of the membranes (11.5%), lethal congenital malformations (10.6%) and hypertensive disorders (7.4%). Cognizant of the frequency of preventable factors, the Consultative Council on Maternal and Perinatal Mortality and Morbidity in Victoria recommends that, where feasible, the mother of these high-risk pregnancies be transferred to a centre where facilities are available to monitor the pregnancy and labour, and which offers intensive care facilities for the baby.
Department of Obstetrics and Gynaecology, University of Melbourne.
J R
JR
Fliegner
D005260:Female; D005313:Fetal Death / Q000209:etiology* / Q000517:prevention & control; D005322:Premature Rupture of Fetal Membranes / Q000209:etiology; D006470:Hemorrhage / Q000628:therapy; D006801:Humans; D007226:Infant Mortality; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007752:Obstetric Labor, Premature / Q000628:therapy; D011225:Pre-Eclampsia / Q000628:therapy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy; D011262:Pregnancy Trimester, Second; D011272:Pregnancy, Multiple; D012189:Retrospective Studies; D002581:Uterine Cervical Incompetence / Q000175:diagnosis / Q000628:therapy; D014739:Victoria