Assessment of “fresh” versus “macerated” as accurate markers of time since intrauterine fetal demise in low-income countries

Abstract Objective To compare provider assessment of fetal maceration with death-to-delivery interval to evaluate the reliability of appearance as a proxy for time of death. Methods Cohort chart abstraction was performed for all stillbirth deliveries at or above 28 weeks of gestation during a 1-year...

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Bibliographic Details
Published in:International journal of gynecology and obstetrics 2014-06, Vol.125 (3), p.223-227
Main Authors: Gold, Katherine J, Abdul-Mumin, Abdul-Razak S, Boggs, Martha E, Opare-Addo, Henry S, Lieberman, Richard W
Format: Article
Language:English
Subjects:
Adolescent
Adult
Cohort Studies
Delivery, Obstetric - statistics & numerical data
Female
Fetal Death
Fetal pathology
Fetus - pathology
Ghana
Hospitals, Teaching
Humans
Low-income country
Maceration
Middle Aged
Obstetrics and Gynecology
Pregnancy
Reproducibility of Results
Stillbirth
Stillbirth - epidemiology
Sub-Saharan Africa
Time Factors
Young Adult
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Summary:Abstract Objective To compare provider assessment of fetal maceration with death-to-delivery interval to evaluate the reliability of appearance as a proxy for time of death. Methods Cohort chart abstraction was performed for all stillbirth deliveries at or above 28 weeks of gestation during a 1-year period in a teaching hospital in Ghana. Results Of 470 stillborn infants, 337 had adequate data for analysis. Of 47 fetuses alive on admission with death-to-delivery intervals estimated to be less than 8 hours (expected to be reported as fresh), 14 (30%) were actually reported as macerated. Of 94 cases in which the fetus was deceased on admission with death-to-delivery interval of more than 8 hours (expected to be macerated), 17 (18%) were described as fresh. Conclusion Provider description of fetal appearance may be an unreliable indicator for time since fetal death. The findings have significant implications for stillbirth prevention and assessment.
ISSN:0020-7292
1879-3479
DOI:10.1016/j.ijgo.2013.12.006