Dødfødsler - En litteraturstudie om utredning, risikofaktorer og forebygging med spesielt fokus på SIUD
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- Profesjonsstudiet medisin [3225]
Abstract
Background: Stillbirth is a major obstetric complication, with nearly 3 million 3rd trimester stillbirths occurring worldwide each year. Despite increasing attention on neonatal health, stillbirths still remain unrecognized and reported data are sparse.Methods: Meta analyses, systematic reviews and population based studies addressing risk factors for stillbirths and guidelines on stillbirth examination, were identified through database searches in; PubMed, Cochrane Library and UpToDate. Papers published 1996-2013 were used and search terms used were; Sudden intrauterine unexplained death, stillbirth, pregnancy outcome etc.
Results: Tools utilized in diagnosing SIUD (Sudden Intrauterine Unexplained Death) are; autopsy, pathologic anatomic diagnosis of the placenta inclusive histology, feto maternal hemorrhage, test for intrauterine infections, oral glucose tolerance testing, chromosomal analyses, autoantibody analyses, thorough medical history, external fetal examination, internal examination, radiological examinations. Significant risk factors for SIUD are; previous obstetric complication, parity, maternal age, ethnicity, BMI, hypertension, diabetes, smoking habits, socioeconomic status/education level, multiple fetuses, fetal growth restriction and antepartum hemorrhage. There are no significant similarities between SIDS (Sudden Infant Death Syndrome) and SIUD in terms of risk factors and determinants.
Conclusions: For stillbirth rate to be reduced globally there needs to be taken action such as; establishing international stillbirth registers and classification system. This will provide more insight into the pathophysiological pathways and result in international guidelines that will enable meaningful comparisons. Further research and studies on risk factors and vulnerable groups are needed, so that we can provide improved antenatal care for future mothers especially in underdeveloped countries.