Contact Person: Alberto G Pizarro (rediegal@homonet.com.mx)

Introduction

The II perinatal mortality we defined the death of stillbirth and neonatal death; A Stillbirth was defined by an estimated gestational age > 20 weeks´gestational age or fetal weight > 500 gr; and the neonatal death from the birth up to 28 days after the childbirth. (1,2,3,4,5)

The II perinatal mortality is a world problem of public health. In our general hospital of level second of medical attention occupies the first place of mortality.

We know that the r correlation and regression between the number of weeks of amenorrhoea and the weight of the stillbirth or newborn it is positive and strong (5); In our hospital and the state of Nayarit ignores the value of this type of correlation.

The causes of II perinatal deaths are many and varied, with a large proportion having no obvious cause. In the evaluation of II perinatal mortality a complete systematic method that incorporates placental pathologic findings, as well as autopsy findings, should prove to be beneficial. ( 6,7)

The factors of risk that affect to this type of mortality are diverse (8,9)

Three factors are important to study of perinatal deaths:

1) Maternal risk factors: diabetes, preeclampsia, urinary tract infection,low maternal weight, a history of pregnancy loss, inadequate prenatal care consultation defined as less than five visits, older mothers, smoked mother, hypertension, anemia, infection, Maternal age, nulliparity and multiparity, tobacco use, previous induced abortions, twins, and others causes. (11,12)

2) Fetal risk factors : unexplained stillbirths were an important component (nearly a quarter) of all perinatal deaths. (9,13,14,15, 15) erytroblastosis, inespecific respitatory distress syndrome, embolia, low weight, congenital anomalies.

3) Pathological findings:

Primary pathologic diagnoses were placental factors (37%), cord complications (28%), and fetal causes (15%), 17% had maternal risk factors only and 3% had no known risk factors. Diagnosis was suggested by pathology in 40% of cases.(17,18)

Causes of fetal death were identified in 65 cases (96%), in which 36 cases (53%) were due to the factors of placenta and its appendix. (7,18,19,20) In a group of 71 intrauterine fetal deaths in monozygotic pregnancies, umbilical cord complications were the cause of death in 11 cases (16%). These included 5 umbilical knots, 3 loops, and one case each of torsion with constriction, umbilical prolapse and velamentous insertion (with rupture of the umbilical vessels (18)

Umbilical cord stricture is an uncommon but distinctive condition associated with intrauterine fetal death. Clinically, a decrease in fetal movements is usually the only symptom during the second or third trimester of pregnancy and fetal death occurs soon after. (19,20)

Morphologically, most infants are macerated and an extremely narrow segment of umbilical cord is usually seen at the fetal end and rarely at the placental end or in multiple sites along the cord. (20,21,22,23)

The purpose of this report is to determine the r correlation coefficient and lineal regression between amenorrhoea and weight of fetuses and neonatos of the II perinatal mortality.

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