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자궁내 태아사망에 관한 임상적 고찰

A Clinical Study for Fetal Death in Utero

대한산부인과학회지 1993년 36권 4호 p.464 ~ 472
정우강
김환/이만재/이두진

Abstract


A clinical analysis of 108 cases of FDIU among 3384 deliveres at Daejeon Eulgi Hospital during 5 years from, January 1986 to December 1990 was made. The incidence of FDIU was 3.19%, the age distribution of mother with FDIU was 20 to 39 years old,
and
the highest group was 25 to 29 years old age group (51.8%). The parity of mother with FDIU was most highest in nulliparous group (58.3%), and there were 11 cases (10.2%) with previous history of spontaneous abortion, only 8.3% of FDIU cases had
previous
history of FDIU. The most common blood type was Rh positive A type (36.1%). The most common gestational weeks when FDIU was detected, was 25 to 28 weeks gestation period (22.2%). The most common presentation was cephalic (80.6%), and the sex
ratio
of
male versus female fetus was 1.35:1, and 78% of FDIU weighing less than 2500gm. The mode of delivery for FDIU was induced labor (74.1%), spontaneous delivery (12%), and laparotomy(13.9%). The causes of FDIU were unexplained cases (41.7%),
followed
chorioamnionitis (12.0%), preeclampsia (10.2%), congenital anomaly(6.5%), maternal illness (5.6%), placental abruption(4.6%), placenta previa (3.7%), syphilis(2.8%), uterine rupture(1.9%), and trauma (0.9%) There were 28 cases (25.9%) of maternal
complication, and the most common complication was hemorrhage(53.6%). The mother who had received antenatal care over 2 times were 95.4% of the cases, even without adequacy in its quality. In the incidence of abnormal coaulation test, the low
platelet
count (50,000~100,000/㎣)was 7.1%, the prolonged partial thromboplastine time(>50sec.) was 1.4%, the hypofibrinogenemia(<150mg/dl) was 5.55%, and the elevated fibrinogen degradation products(>40㎍/ml)was 12.5%.
The incidence of FDIU by early detection during prenatal care of the risk factors related to FDIU. Early diagnosis and early treatment must be given to prevent maternal complications.

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