Hospital setting and fetal death during labor among women at low risk

Article Abstract:

Perinatal mortality, deaths occurring from week 28 of gestation to day 28 of life, more often involves fetal death. Fetal death is associated with very young or very old pregnant women; women who have delivered many children; those who smoke, have medical problems; or are socially disadvantaged. Almost 13 percent of fetal deaths occur during labor, but the effect that the type of hospital facility has on the incidence of perinatal fetal deaths in low-risk women is not clear. Data from two 1980 surveys were analyzed to assess this relationship. Hospitals were classed as Level III (teaching hospitals), Level II (other urban hospitals), or Level I (rural hospitals). The risk of fetal death during delivery was twice as high in Level II than Level III hospitals, and 3.3-fold higher in Level I hospitals. The lower risk for fetal deaths in Level III hospitals was not associated with a postponement of deaths to the newborn period. The study indicated that hospital size, volume of deliveries, teaching status, and increased nursery capabilities, all features which differed among different level hospitals, can influence the risk of intrapartum fetal death among low-risk women. The components of care at Level III hospitals associated with better outcome need to be determined to improve outcome at other level hospitals. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Evaluation, Infant mortality, Pregnancy, Complications of, Pregnancy complications, Perinatal death, Hospitals, Gynecologic and obstetric, Gynecologic and obstetric hospitals

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Clinical risk factors for placenta previa-placenta accreta

Article Abstract:

Placenta accreta appears to be a rather rare condition but certain factors may increase its risk. Placenta accreta involves the placenta invading the uterine wall whereas placenta previa involves the placenta blocking the birth canal. Medical records of 155,670 deliveries between 1985 and 1994 were analyzed for the occurrence of placenta accreta and to identify any predisposing risk factors. Overall, 62 women had placenta accreta. Multiple cesarean deliveries complicated by placenta previa placed women at a 39% risk for placenta accreta. Risk was higher for women with placenta previa if they were older or had had a cesarean.

Health aspects, Cesarean section, Placenta praevia, Placenta previa, Placenta accreta

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