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Intrauterine deaths — an unsolved problem in Polish perinatology

Tomasz Gora12, Kamila A. Wojtowicz1, Maja Drozdzak1, Pawel Guzik1, Jakub Kornacki3, Katarzyna Kosinska-Kaczynska4, Anna Kajdy56, Stepan Feduniw5, Przemyslaw Kosinski7, Anna Szczepkowska8, Dorota Darmochwal-Kolarz9, Pawel Tos9, Tomasz Kluz10, Anna Zymroz10, Magda Rybak-Krzyszkowska2, Hubert Huras2, Boguslawa Piela11, Marzena Malec11, Ewa Banas-Fiebrich11, Ewa Janowska-Tyc11, Katarzyna Stefanska12, Malgorzata Swiatkowska-Freund12, Agnieszka Mrozinska13, Magdalena Bednarek-Jedrzejek14, Aleksandra Kukla14, Dominika Boboryko14, Urszula Warejko14, Dorota Sys6, Sebastian Kwiatkowski14

Abstract

Objectives: The Polish criteria for “intrauterine death” include fetal demise after 22 weeks of gestation, weighing > 500 g and body length at least 25 cm, when the gestational age is unknown. The rate of fetal death in Poland in 2015 is 3:10,000. In 2020, 1,231 stillbirths were registered. Material and methods: An analysis using 142,662 births in the period between 2015–2020 in 11 living in Poland. The first subgroup was admitted as patients > 22 to the beginning of the 30th week of pregnancy (n = 229), and the second from the 30th week of pregnancy inclusively (n = 179). In the case of women from both subgroups, there was a risk of preterm delivery close to hospitalization. Results: It was found that stillbirth in 41% of women in the first pregnancy. For the patient, stillbirth was also the first in his life. The average stillbirth weight was 1487 g, the average body length was 40 cm. Among fetuses up to 30 weeks, male fetuses are born more often, in subgroup II, the sex of the child was usually female. Most fetal deaths occur in mothers < 15 and > 45 years of age. Conclusions: According to the Polish results of the origin of full-term fetuses > 30 weeks of gestation for death in the concomitant antenatal, such as placental-umbilical and fetal hypoxia, acute intrapartum effects rarely, and moreover < 30 Hbd fetal growth restriction (FGR), occurring placental-umbilical, acute intrapartum often.

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