Fetal death: Obstetric, placental and fetal necroscopic factors

Abstract

Introduction: Fetal death is defined as the death of the product of conception, regardless of gestational age. Objectives: The objective of this study was to investigate the maternal (obstetrical and placental) risk factors and the necropsy findings associated with fetal death, based on data obtained from the Verification of Death Service [Serviço de Verificação de Óbito (SVO)] in Florianópolis, Santa Catarina, Brazil. Material and method: This is an observational, cross-sectional study using secondary data. Were included the reports released between 2010 and 2015, with a diagnosis of fetal deaths at gestational age of 20 weeks or more. Results: During the period evaluated, 210 autopsies were performed. From these, 15.2% (n = 32) presented umbilical cord abnormalities, 22.4% (n = 47) placental abnormalities, 49.5% (n = 104) maternal health problem related to pregnancy, and 10% (n = 21) previous maternal disease. Among the fetal characteristics involved, it was observed that 6.7% (n = 14) presented meconium aspiration and 5.2% (n = 11) fetal malformations. In this study, 21.9% (n = 46) did not have their causa mortis defined. Discussion: The findings of this study show a statistically significant association (p < 0.05) between meconium aspiration and full term pregnancy, hospital origin and normal birth weight. Such information is in agreement with the literature, which shows signs of intrauterine hypoxia, such as the presence of meconium, which are more prevalent in full term pregnancy. Conclusion: Among the causes of fetal death, ascending infection was the most prevalent; the maternal death related to pregnancy were the ones that stood out the most.