ETIOLOGY OF LATE FETAL DEATH IN MAPUTO

Background: To study the etiology of late fetal death in Maputo. Patie nts: Stillbirths (n = 163) in Maputo were compared to 207 live births. Results: A probable cause of fetal death could be determined in 112 c ases (69%). Hypertension was the most common factor associated with st illbirth and occurred in 14% of the fetal deaths, followed by abruptio n of the placenta (13%), syphilis (8%), clinical intra-uterine infecti on (6%), malaria (4%), fetal malformation (4%), umbilicial cord compli cations (4%) and anaemia (4%). Mothers of stillborns and referent moth ers differed in the following parameters: fetal weight, gestational ag e, numbers of previous stillbirths, haemoglobin, packed cell volume (p < 0.001), age, number of pregnancies (p < 0.01), parity, number of li ve children and skinfold thickness (p < 0.05). In the stillborn cases where no probable cause of fetal death was established, newborn weight was significantly lower and estimated gestational age significantly s horter (p < 0.001), number of previous pregnancies and number of previ ous stillbirths were significantly larger (p < 0.05) than in the refer ent group, but otherwise no significant differences were found. In two randomly selected subgroups, 28 mothers with stillbirth without proba ble diagnoses, and in 24 referent mothers, selected serum proteins and acute-phase reactants were determined. There were no statistically si gnificant differences in the mean values of haptoglobin, pre-albumin, retinol-binding protein and alpha(1)-azntitrypsin in the two subgroups . The stillbirth subgroup had significantly higher mean values of C-re active protein and serum orosomucoid than the referent group (p < 0.01 ). Conclusion: Signs of maternal illness were present in one third of the mothers with stillbirth, and half of them required medical care. I n one third there was no final diagnosis, but these mothers showed sig nificantly higher mean values of acute phase reactants, suggesting low -grade infection.