Método de clasificación de mortinatos según condición obstétrica relevante de la muerte fetal, en un hospital público de Chile (Método CORM)
Author
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Ovalle, Alfredo
Author
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Fuentes Garcia, Frans Ariel
Author
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Chacón, Valentina
Author
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Espinoza Zamorano, Carolina Andrea
Author
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González, Rodrigo
Author
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Ramos, Manuel
Author
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Geraldo, Jorge
Author
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Osses, Letsy
Author
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Kakarieka, Elena
Admission date
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2017-03-02T14:14:00Z
Available date
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2017-03-02T14:14:00Z
Publication date
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2016
Cita de ítem
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Rev. Med. Chile. 2016; 144: 1020-1028
es_ES
Identifier
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10.4067/S0034-98872016000800009
Identifier
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https://repositorio.uchile.cl/handle/2250/142941
Abstract
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Stillbirth is the mayor contributor to perinatal mortality. Aim:
To report a system for classification of fetal deaths. Material and Methods:
Retrospective cohort study of 29,916 births with 258 fetal deaths that occurred
in a public hospital. Data were obtained from audit reports of stillbirths. The
method for classification “obstetric condition relevant to the death” was applied,
based on obstetric and placental pathological findings analyzed exclusively by
a single obstetrician and a single pathologist. Results: Ninety two percent of
obstetric conditions causing fetal death were identified. The most commonly
reported were ascending bacterial infection in 26%, congenital anomalies in
19%, arterial hypertension in 12% and placental pathology in 12%. Fetal growth
restriction was identified in 50% of stillbirths. Ninety percent were secondary
to a primary obstetric condition and 10% had an unexplained cause. Placental
abruption as the final cause of fetal death was identified in 60% of cases with
arterial hypertension, 43% of cases with placental pathology and 37% of ascending
infections. Fetal deaths occurred during pregnancy in 82% of cases and
during labor in 17%. Intrapartum asphyxia occurred in 0.8% of stillbirths and
presented in term pregnancies. Conclusions: The “obstetric condition relevant
to the death” method for classification of fetal death is effective to identify the
originating obstetric cause of stillbirth and reduces the impact of fetal growth
restriction and intrapartum asphyxia as the leading causes of death.