What reason is fetal death caused by intrauterine?

summary

Intrauterine fetal death refers to the fact that the fetus has died before the pregnancy products are completely eliminated from the mother. The early fetal death is less than 20 weeks of gestation, and the middle and late fetal death respectively refers to 20-27 weeks of gestation and more than 28 weeks of gestation. Who defines fetal death as no breathing or any other signs of life, such as heartbeat, umbilical cord pulsation or definite random muscle movement. What is the cause of intrauterine fetal death? Let's talk about it.

What reason is fetal death caused by intrauterine?

(1) Chromosomal abnormalities: in the late 1960s, Carr of Canada and boues of France confirmed under light microscope that chromosomal abnormalities are an important cause of human fetal death. Now a large number of studies have elaborated the relationship between specific fetal chromosomal abnormalities and gestational age, parental age, birth history and fetal morphology. Compared with rodents, the pregnancy rate of human chromosomal abnormalities is very high, and these pregnancies will lead to embryo / fetal death. The incidence rate of chromosomal diseases has decreased linearly with gestational weeks. The highest incidence of abortion is 15% in 6-15 weeks, 6% in stillbirth (after 20 weeks), and only 0.5% in neonatal death. Therefore, only a few chromosomal diseases can be seen in live birth newborns.

(2) Fetal non chromosomal malformations: about 1 / 4 of fetal deaths have malformations, and nearly 50% of malformations are caused by non chromosomal aberrations, which are also the main causes of spontaneous abortion and stillbirth. However, not all malformations can be diagnosed before birth, and the detection rate of malformations is only 22.3%. The diagnosis of single malformation such as anencephaly or other neural tube malformations is relatively simple, but 12% of neural tube malformations are part of multiple congenital malformation syndrome. The malformations caused by non chromosomal abnormalities related to stillbirth are listed in Table 2.

(3) In all the above cases, the average incidence of stillbirth was 30%. Congenital heart disease is the most common malformation, with an incidence of about 8 / 1000, and 3 of the 8 cases are severe malformations. The perinatal mortality of congenital heart disease is quite high, most of them die in utero or early postpartum. The incidence rate of congenital heart disease is 1 times higher than that of diabetes mellitus. Incidence rate of congenital ketopathy is also increased. If the pregnant woman had one child with congenital heart disease, the recurrence rate was 1% - 3%. If the pregnant woman had two children with congenital heart disease, it increased to 10%.

matters needing attention

According to the investigation of the medical, social and economic status of pregnant women, they were divided into high-risk group and low-risk group. The intrauterine mortality rates were 5.4% and 1.3% respectively. Therefore, strengthening the monitoring of high-risk pregnant women can also reduce part of fetal death. 2. Fetal movement is the most simple, economical and convenient means of monitoring, which can be monitored by pregnant women themselves. Fetal distress should be considered if fetal movements are less than 10 times within 12 hours or more than 50% per day. In high-risk pregnancies, decreased placental function can lead to decreased fetal movement before the change of fetal heart rate (sedatives or magnesium sulfate should be excluded). If the fetal activity increases sharply and then stops, it often indicates that the fetus died of acute intrauterine hypoxia, which is mostly caused by umbilical cord compression and placental abruption.