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Declining autopsy rates in stillbirths and infant deaths: results from Funen County, Denmark, 1986-96.

https://arctichealth.org/en/permalink/ahliterature58363
Source
J Matern Fetal Neonatal Med. 2003 Jun;13(6):403-7
Publication Type
Article
Date
Jun-2003
Author
K F Kock
V. Vestergaard
M. Hardt-Madsen
E. Garne
Author Affiliation
Institute of Pathology, Odense University Hospital, Denmark.
Source
J Matern Fetal Neonatal Med. 2003 Jun;13(6):403-7
Date
Jun-2003
Language
English
Publication Type
Article
Keywords
Autopsy - statistics & numerical data
Death Certificates
Denmark - epidemiology
Diagnostic Errors - statistics & numerical data
Female
Fetal Death - diagnosis - epidemiology
Humans
Infant mortality
Infant, Newborn
Pregnancy
Retrospective Studies
Sudden Infant Death - epidemiology
Abstract
OBJECTIVE: The aim of this study was to describe the development of the autopsy rate in stillbirths and infant deaths in an 11-year period and evaluate the information gained by performing an autopsy. METHODS: Included in the study were all stillbirths and infant deaths in Funen County, Denmark, in 1986-96. Data sources were death certificates and autopsy reports. RESULTS: The study included 273 stillbirths and 351 deaths in infancy. The rates of stillbirth and infant death did not change significantly during the period. The overall autopsy rate for stillbirths was 70% and for infant deaths 57%. There was a significant decline in autopsy rate during the years 1991-96 as compared with 1986-90 for stillbirths, infant deaths and infant deaths excluding sudden infant death syndrome. In stillbirth, the autopsy changed the diagnosis in 9% of the cases. In 22%, the clinical diagnosis was maintained, but additional information was obtained. In infant death, the numbers were 10% and 40%, respectively. CONCLUSION: In 10% of the autopsies the diagnosis was changed completely, with an impact on genetic counseling as well as on statistical records of causes of death in fetuses and infants. With additional information in 22-40% of the autopsies, the study emphasizes autopsy as a useful investigation.
PubMed ID
12962266 View in PubMed
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Diagnostic evaluation of intrauterine fetal deaths in Stockholm 1998-99.

https://arctichealth.org/en/permalink/ahliterature63690
Source
Acta Obstet Gynecol Scand. 2002 Apr;81(4):284-92
Publication Type
Article
Date
Apr-2002
Author
Karin Petersson
Katarina Bremme
Roger Bottinga
Alexandra Hofsjö
Ingela Hulthén-Varli
Marius Kublickas
Margareta Norman
Nikos Papadogiannakis
Kjell Wånggren
Kerstin Wolff
Author Affiliation
Department of Obstetrics and Gynecology at Huddinge University Hospital, Stockholm, Sweden. karin.petersson@obgyn.hs.sll.se
Source
Acta Obstet Gynecol Scand. 2002 Apr;81(4):284-92
Date
Apr-2002
Language
English
Publication Type
Article
Keywords
Cause of Death
Female
Fetal Death - diagnosis - epidemiology - etiology
Gestational Age
Humans
Logistic Models
Pregnancy
Pregnancy Complications - diagnosis - epidemiology
Pregnancy Complications, Infectious - diagnosis - epidemiology
Prospective Studies
Research Support, Non-U.S. Gov't
Risk factors
Sweden - epidemiology
Abstract
BACKGROUND: To evaluate the diagnostic methods and to elucidate the etiology of intrauterine fetal death. MATERIAL AND METHODS: A prospective study was conducted on all intrauterine fetal deaths occurring in Stockholm County in 1998-99. During a 24-month period, 188 cases of intrauterine fetal death with gestational ages of > or = 22 weeks were investigated in accordance with structured test protocol. All information from antenatal and delivery records as well as all test results were entered in to an Internet-based database for continuous evaluation. RESULTS: A presumptive explanation to the stillbirth was established in 91% of the cases. The most common factors associated with intrauterine fetal death could be identified as infections (24%), placental insufficiency/intrauterine growth restriction (22%), placental abruption (19%), intercurrent maternal conditions (12%), congenital malformations (10%), and umbilical cord complications (9%). CONCLUSIONS: A relevant test protocol in cases of intrauterine fetal death reduces the number of unexplained cases to a minimum. An Internet-based register on test results of fetal deaths may enable a continuous evaluation of the diagnostic tools and etiologic factors in an ever-changing panorama. The results from the present study can serve as a base for a case-control study in Sweden.
Notes
Erratum In: Acta Obstet Gynecol Scand. 2003 Jan;82(1):102
PubMed ID
11952456 View in PubMed
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[Perinatal deaths in the county of Ostfold 1989-97]

https://arctichealth.org/en/permalink/ahliterature58886
Source
Tidsskr Nor Laegeforen. 1999 Apr 10;119(9):1272-5
Publication Type
Article
Date
Apr-10-1999
Author
D. Fossen
I E Silberg
Author Affiliation
Kvinneklinikken, Sykehuset Ostfold, Fredrikstad.
Source
Tidsskr Nor Laegeforen. 1999 Apr 10;119(9):1272-5
Date
Apr-10-1999
Language
Norwegian
Publication Type
Article
Keywords
Birth weight
Cause of Death
English Abstract
Female
Fetal Death - diagnosis - epidemiology - prevention & control
Fetal Growth Retardation - diagnosis
Humans
Infant mortality
Infant, Newborn
Maternal Health Services - standards
Maternal Welfare
Norway - epidemiology
Perinatal Care - standards
Pregnancy
Pregnancy Complications - diagnosis - prevention & control
Quality Assurance, Health Care
Abstract
All perinatal deaths in the county of Ostfold during the nine year period 1989-1997 were assessed by perinatal audit. Each death was allocated to one of two groups: satisfactory or suboptimal perinatal care. The classification of the causes of death includes fetal, obstetrical and neonatal conditions. The audit is supplemented with some epidemiological data. It was concluded that the standard of care was suboptimal in a fourth of the evaluated cases (52 out of 212). Misdiagnosed or ignored growth retardation and inadequate reaction to information of reduced fetal movements, were the two most frequent examples of suboptimal care. Perinatal mortality was 6.7 per thousand. The results of this audit indicate that it should be possible to improve the quality of perinatal care by intensifying the postgraduate training of the personnel involved. Pregnant woman should contribute by refraining from smoking. The national perinatal committees should aim at establishing a common standard for perinatal audits which would allow tenable comparisons of audit results and national surveys.
PubMed ID
10327848 View in PubMed
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[The significance of a mixed congenital viral infection in human antenatal and perinatal pathology].

https://arctichealth.org/en/permalink/ahliterature218742
Source
Vopr Virusol. 1994 Mar-Apr;39(2):74-7
Publication Type
Article
Author
L S Lozovskaia
N A Shumskaia
Z A Mukhitdinova
R G Desiatskova
L K Ebralidze
N V Karazhas
Source
Vopr Virusol. 1994 Mar-Apr;39(2):74-7
Language
Russian
Publication Type
Article
Keywords
Antigens, Viral - analysis
Fetal Death - diagnosis - epidemiology - etiology
Fetal Diseases - diagnosis - epidemiology - etiology
Humans
Incidence
Infant, Newborn
Moscow - epidemiology
Prevalence
Risk factors
Seroepidemiologic Studies
Virus Diseases - congenital - diagnosis - epidemiology - transmission
Viruses - isolation & purification
Abstract
Examinations of 202 newborn babies for a representative group of viral infections by detection of viral antigens in cells of urine sediment and in the autopsy materials by indirect immunofluorescence permitted diagnosis of a congenital viral infection in 92% of patients with intrauterine and perinatal pathology; in 72.5% it was a mixed infection. In the patients the virus-virus associations were, as a rule, represented by enteroviruses of Coxsackie group and/or influenza A, B, and C viruses. Most frequently (83.3-100%) mixed virus infection was detected in newborn babies with the severest pathology (meningoencephalitis, encephalitis, sepsis, intrauterine pneumonia), as well as in fatal cases.
PubMed ID
8017058 View in PubMed
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[When the expected child dies. Both emotional and practical support is important for the women affected]

https://arctichealth.org/en/permalink/ahliterature64104
Source
Lakartidningen. 1999 Mar 17;96(11):1311-5
Publication Type
Article
Date
Mar-17-1999
Author
I. Rådestad
Author Affiliation
Institutionen för kvinnors och barns hälsa, Karolinska institutet, Stockholm. ingela.radestad@mdh.se
Source
Lakartidningen. 1999 Mar 17;96(11):1311-5
Date
Mar-17-1999
Language
Swedish
Publication Type
Article
Keywords
Adaptation, Psychological
Anxiety Disorders - diagnosis - etiology
English Abstract
Female
Fetal Death - diagnosis - epidemiology
Grief
Guidelines
Humans
Labor, Induced
Maternal Welfare
Patient satisfaction
Postpartum Period
Pregnancy
Questionnaires
Social Support
Sweden - epidemiology
Women's health
Abstract
The results of a nationwide population-based epidemiological study of 636 women showed the majority of those who lost a child prenatally in 1991 to have been satisfied with the care they received. After a stillbirth it is beneficial to create a peaceful, supportive atmosphere in which the woman may spend as much time with her stillborn child as she wishes. Access to tangible reminders of the child reduces the risk of anxiety. The findings suggest that delivery should be induced as soon as the woman desires. Almost all the women stressed the importance of obtaining an adequate explanation of the child's death, in order to come to terms with their loss.
PubMed ID
10194910 View in PubMed
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7 records – page 1 of 1.