PROFILE OF NEONATAL DEATHS

A STUDY IN A GOIÂNIA PUBLIC MATERNITY

Abstract

Introduction: The World Health Organization (WHO) defines fetal death as that which occurs before the complete expulsion or extraction of the product from the conception of the maternal organism, regardless of the duration of pregnancy Objectives: To trace the profile of fetal deaths in a public maternity hospital in Goiânia. Describe the main causes of fetal death. Analyze the characteristics of deaths occurred and declared. Analyze risk factors associated with the occurrence of fetal death. Methods: Retrospective cross-sectional ecological study. Results: The main factors that culminated in fetal death are 18.5% Premature Labor. The main cause of fetal death was prematurity with 28%. The unit’s fetal mortality rate is 22.8 deaths per 1000 births, but the profile is of high risk, which justifies the data. As for the maternal factors presented and related to fetal deaths, it was observed that of 131 (95.6%) pregnancies with one or more children, 104 (75.9%) were born alive, while 64 (46.7%) were born dead. Of these pregnant women, 27 (19.7%) had one or more abortions; 20 (14.7%) had ruptured amniotic membranes and 36 (26.3%) ruptured pouch during pregnancy. Among all the pregnant women evaluated, 22 (16%) presented Systemic Arterial Hypertension as the main complication in the current pregnancy. Among the factors associated with pregnancy and which led to fetal death, Prematurity was found in 39 (18.5%) of pregnant women. In this study, it was also found that 96 (65.3%) of the pregnant women did not use medication during pregnancy and, when used, the main drugs were antihypertensive drugs 14 (9.5%). As a condition for hospitalization, 42 (31%) pregnant women died of fetal death and motherhood was the place where the majority of births occurred, 133 (97%). Of all deliveries performed, 90 (65.7%) were vaginal, and in 98 (71.5%) the obstetrician was the professional who conducted the procedure. When cesarean section was indicated, acute fetal distress was the deciding factor in 12 patients, totaling 25.2% of all pregnant women whose indication for delivery was surgical. The prevailing gestational age in 75 (54.7%) had less than 31 weeks of gestation that constitutes extreme preterm, with a predominant weight in 66 (48.2%) <1000 grams being classified in extremely low weight. The presence of meconium was present in 30 (22%) of fetal deaths. Conclusion: Regarding the observed fetal characteristics, the following deaths were found: male, extreme preterm (<31 weeks), extremely low birth weight (<100g), normal birth. An important data that draws attention was the large amount of underreporting in relation to the type of anesthesia performed during cesarean section, neonatal resuscitation and birth conditions. It was observed that almost half of those born were not sent to the autopsy service. Having found arterial hypertension as the main cause of fetal death in this population is not surprising, since other studies carried out in the country have identified this same cause.