INTRAUTERİN FETUS ÖLÜMÜ: ETYOLOJİSİ VE ÖNLENMESİ

Intrauterin fetus ölümü (IUFÖ) Dünya Sağlık Örgütünün tanımına göre 20. gebelik haftasından sonraki ve ya gestasyonel hafta bilinmiyorsa normal gelişen bir fetusda 500 gr. üstünde doğum ağırlığına sahip fetusun intrauterin kaybıdır. 500 gr üstü fetus da yaklaşık olarak 22. gebelik haftasına tekabül eder (2). IUFÖ çok sık görülmemekle birlikte ani yenidoğan ölümü sıklığından 10 kat daha fazladır (1). 2002 yılında Amerika Birleşik Devletleri’nde, 26,000 IUFÖ kaydedilmiş olup bu ‘6.4/1,000 toplam doğum sayısı’ oranına karşılık gelmektedir. Aynı yıl 28,000 infant ölümü (7.0/1,000 canlı doğum) ve 19,000 yenidoğan ölümü (4.7/1000 canlı doğum) meydana gelmiştir (3). 1950’lerden sonra IUFÖ hızında azalma olmuştur, fakat bu azalma yenidoğan ölüm hızındaki azalmadan daha azdır. Geniş serilerde IUFÖ gebelik haftasına göre ikiye ayrılmıştır, 20-28 gebelik haftası arası erken fetal kayıplar, 29. gebelik haftası ve sonrası geç fetal kayıplar olarak sınıflandırılmıştır (3). Bu sınıflandırma etyolojide önemlidir, erken gebelik haftalarında meydana gelen kayıplarda büyük çoğunluğu enfeksiyonlar oluştururken herhangi bir neden bulunamazsa ‘açıklanamayan’ olarak sınıflandırılır (4).

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INTRAUTERİN FETUS ÖLÜMÜ: ETYOLOJİSİ VE ÖNLENMESİ

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