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Perinatal Mortality and Morbidity of Growth Restricted Fetuses and Newborns (own Experience) – First Report

AIM: to evaluate the outcome of pregnancies complicated by fetal growth restriction with particular emphasis on the factors (fetal and maternal) related to perinatal mortality and morbidity of the fetus and newborn. MATERIAL AND METHODS: Retrospective analysis of the documentation of 53 women admitt...

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Autores principales: Pankiewicz, Katarzyna, Maciejewski, Tomasz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sciendo 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8522985/
https://www.ncbi.nlm.nih.gov/pubmed/28551689
http://dx.doi.org/10.34763/devperiodmed.20172101.2934
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author Pankiewicz, Katarzyna
Maciejewski, Tomasz
author_facet Pankiewicz, Katarzyna
Maciejewski, Tomasz
author_sort Pankiewicz, Katarzyna
collection PubMed
description AIM: to evaluate the outcome of pregnancies complicated by fetal growth restriction with particular emphasis on the factors (fetal and maternal) related to perinatal mortality and morbidity of the fetus and newborn. MATERIAL AND METHODS: Retrospective analysis of the documentation of 53 women admitted with the diagnosis of fetal growth restriction based on ultrasound examination (fetal biometry and fetal vessel Doppler abnormalities). 38 (71.7%) patients were referred to our department with the diagnosis of fetal growth restriction, whereas 15 (28.3%) cases were diagnosed in our hospital. 32 (60.4%) women were referred to our department by their main obstetrician, 13 (24.5%) by other hospitals and 8 (15.1%) came to triage because of worrisome symptoms. The patients were divided into 2 groups according to the presence of fetal/neonatal complications: the first group (n=14) - with complications (defined as one or more of the following: stillbirth, neonatal death, respiratory distress syndrome (RDS), intraventricular haemorrhage (IVH) Grade III or IV , necrotic enterocolitis (NEC), proven neonatal sepsis or bronchopulmonary dysplasia (BPD)) and the second one (n=39) – without severe complications. RESULTS: Gestational age at diagnosis and at delivery was lower in the first group (28.5 weeks vs. 32.15 weeks, p=0.003 and 29.2 weeks vs. 32.8 weeks, p=0.0004). Female fetuses predominated in the second group (64.1%), whereas male fetuses in the first group (64.3%). In both groups the majority of patients delivered by cesarean section (92.9% vs. 97.4% p=0.44). Birth weight was significantly lower in the first group (774g vs. 1416g, p<0.0001). Perinatal morbidity (severe neonatal complications) occurred in 14 (26.4%) cases. The fetal and newborn perinatal mortality rate in the studied group was 13.19% (in comparison to 0.6% for the entire population of pregnant women in Poland). CONCLUSIONS: 1. Gestational age (at diagnosis and at delivery) and birth weight are the most important prognostic factors related to the adverse outcome in the management of fetal growth restriction. 2.The most common mode of delivery for fetuses with growth restriction is the cesarean section. 3. Early detection of fetal growth restriction in routine perinatal care seems to be insufficient. 4. Fetal and newborn perinatal mortality and morbidity rates in fetal growth restriction are still high and the management of such pregnancies should take place in reference obstetric units, where detailed diagnostics, monitoring and treatment of fetal and neonatal complications can be performed.
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spelling pubmed-85229852021-11-19 Perinatal Mortality and Morbidity of Growth Restricted Fetuses and Newborns (own Experience) – First Report Pankiewicz, Katarzyna Maciejewski, Tomasz Dev Period Med Original Articles/Prace Oryginalne AIM: to evaluate the outcome of pregnancies complicated by fetal growth restriction with particular emphasis on the factors (fetal and maternal) related to perinatal mortality and morbidity of the fetus and newborn. MATERIAL AND METHODS: Retrospective analysis of the documentation of 53 women admitted with the diagnosis of fetal growth restriction based on ultrasound examination (fetal biometry and fetal vessel Doppler abnormalities). 38 (71.7%) patients were referred to our department with the diagnosis of fetal growth restriction, whereas 15 (28.3%) cases were diagnosed in our hospital. 32 (60.4%) women were referred to our department by their main obstetrician, 13 (24.5%) by other hospitals and 8 (15.1%) came to triage because of worrisome symptoms. The patients were divided into 2 groups according to the presence of fetal/neonatal complications: the first group (n=14) - with complications (defined as one or more of the following: stillbirth, neonatal death, respiratory distress syndrome (RDS), intraventricular haemorrhage (IVH) Grade III or IV , necrotic enterocolitis (NEC), proven neonatal sepsis or bronchopulmonary dysplasia (BPD)) and the second one (n=39) – without severe complications. RESULTS: Gestational age at diagnosis and at delivery was lower in the first group (28.5 weeks vs. 32.15 weeks, p=0.003 and 29.2 weeks vs. 32.8 weeks, p=0.0004). Female fetuses predominated in the second group (64.1%), whereas male fetuses in the first group (64.3%). In both groups the majority of patients delivered by cesarean section (92.9% vs. 97.4% p=0.44). Birth weight was significantly lower in the first group (774g vs. 1416g, p<0.0001). Perinatal morbidity (severe neonatal complications) occurred in 14 (26.4%) cases. The fetal and newborn perinatal mortality rate in the studied group was 13.19% (in comparison to 0.6% for the entire population of pregnant women in Poland). CONCLUSIONS: 1. Gestational age (at diagnosis and at delivery) and birth weight are the most important prognostic factors related to the adverse outcome in the management of fetal growth restriction. 2.The most common mode of delivery for fetuses with growth restriction is the cesarean section. 3. Early detection of fetal growth restriction in routine perinatal care seems to be insufficient. 4. Fetal and newborn perinatal mortality and morbidity rates in fetal growth restriction are still high and the management of such pregnancies should take place in reference obstetric units, where detailed diagnostics, monitoring and treatment of fetal and neonatal complications can be performed. Sciendo 2017-05-29 /pmc/articles/PMC8522985/ /pubmed/28551689 http://dx.doi.org/10.34763/devperiodmed.20172101.2934 Text en © 2017 Katarzyna Pankiewicz, Tomasz Maciejewski, published by Sciendo https://creativecommons.org/licenses/by/4.0/This work is licensed under the Creative Commons Attribution 4.0 International License.
spellingShingle Original Articles/Prace Oryginalne
Pankiewicz, Katarzyna
Maciejewski, Tomasz
Perinatal Mortality and Morbidity of Growth Restricted Fetuses and Newborns (own Experience) – First Report
title Perinatal Mortality and Morbidity of Growth Restricted Fetuses and Newborns (own Experience) – First Report
title_full Perinatal Mortality and Morbidity of Growth Restricted Fetuses and Newborns (own Experience) – First Report
title_fullStr Perinatal Mortality and Morbidity of Growth Restricted Fetuses and Newborns (own Experience) – First Report
title_full_unstemmed Perinatal Mortality and Morbidity of Growth Restricted Fetuses and Newborns (own Experience) – First Report
title_short Perinatal Mortality and Morbidity of Growth Restricted Fetuses and Newborns (own Experience) – First Report
title_sort perinatal mortality and morbidity of growth restricted fetuses and newborns (own experience) – first report
topic Original Articles/Prace Oryginalne
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8522985/
https://www.ncbi.nlm.nih.gov/pubmed/28551689
http://dx.doi.org/10.34763/devperiodmed.20172101.2934
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