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Multidisciplinary Workup for Stillbirth at a Tertiary-Care Hospital in Northeast Mexico: Findings, Challenges and Perspectives

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Abstract

Objectives

Stillbirth is an important health problem, and in Mexico, only half of the stillbirths have an explainable cause. The aim of this study was to implement a multidisciplinary workup to identify the etiology and potential risk factors for stillbirth at the Hospital Universitario “Dr. José Eleuterio González”.

Methods

This is a prospective, descriptive, observational study that included stillbirths from the Obstetrics Service from October 1st, 2019 to May 25, 2020. Evaluation strategies included a complete maternal medical history, physical examination of the fetus, and a photographic medical record. For every stillbirth either a prenatal ultrasound, a postnatal x-ray, or a fetal autopsy, were needed. Multiplex Ligation Probe Amplification (MLPA) was performed with an umbilical cord sample.

Results

Thirty-three stillbirths were reported; 21 were included in the analysis. Eleven women (52.3%) had known risk factors for stillbirth, mainly elevated body mass index and diabetes. On physical examination, external birth defects were found in 8 fetuses (38%). X-ray was performed in 14 cases (66%), alterations were detected as a probable etiologic cause just in one. All cases underwent MLPA, which were reported negative. Three cases had criteria for autopsy. Findings were inconclusive to determine etiology.

Conclusions

The best tools for evaluation of stillbirth were the elaboration of clinical history, physical examination, and prenatal ultrasound. Diabetes and obesity were the most frequent risk factors found in our population. These factors are preventable by implementing strategies that lead to better prenatal care.

Significance

Stillbirth is a health problem whose causes are rarely evaluated and explained to the families that go through this situation. To completely explain the causes of stillbirth a complete workup should be performed, where a multidisciplinary participation is needed. Mainly these workups have been performed retrospectively, however we introduce a complete evaluation of stillbirth since the moment of arrival to obstetrics department and performing evaluations for fetal, maternal or combined causes, including genetic testing; detecting key health issues in our population, that can be prevented with an adequate prenatal care.

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Data Availability

Data are available upon reasonable request.

Code Availability

Not applicable.

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Funding

The project was funded with resources of the Genetics Department as well as the Radiology and Pathology Departments of the Hospital Universitario “Dr. José Eleuterio González,” Universidad Autónoma de Nuevo León.

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Authors and Affiliations

  1. Department of Genetics, Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario “Dr. José Eleuterio González”, Monterrey, Mexico

    Kiabeth Robles Espinoza, Graciela Arelí López Uriarte, Gloria Beatriz García Castañeda, Iris Torres Muñoz, José de Jesús Lugo Trampe & Laura Martínez de Villareal

  2. Department of Radiology and Imaging, Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario “Dr. José Eleuterio González”, Monterrey, Mexico

    Guillermo Elizondo Riojas

  3. Department of Pathologic Anatomy, Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario “Dr. José Eleuterio González”, Monterrey, Mexico

    Oralia Barboza Quintana & Marco Ponce Camacho

  4. Gynecology and Obstetrics Service, Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario “Dr. José Eleuterio González”, Monterrey, Mexico

    Abel Guzmán López

Authors
  1. Kiabeth Robles Espinoza
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  2. Graciela Arelí López Uriarte
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  3. Gloria Beatriz García Castañeda
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  4. Iris Torres Muñoz
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  5. José de Jesús Lugo Trampe
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  6. Guillermo Elizondo Riojas
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  7. Oralia Barboza Quintana
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  8. Marco Ponce Camacho
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  9. Abel Guzmán López
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  10. Laura Martínez de Villareal
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Contributions

KR-E: Project development, sample collection, patient evaluation, data collection, tissue processing, data analysis, manuscript writing. GAL-U: Project development, data analysis, manuscript writing/editing. GBG-C: Tissue processing. IT-M: Tissue processing and analysis. JJL-T: Tissue processing and analysis. GE-R: Project development OB-Q: Project Development MP-C: Project Development AG-L: Project Development LMV: Project development, data analysis, manuscript writing/editing.

Corresponding authors

Correspondence to Kiabeth Robles Espinoza or Graciela Arelí López Uriarte.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical Approval

The study was approved by the Ethics Committee of the Facultad de Medicina and Hospital Universitario, Universidad Autónoma de Nuevo León with registration number GN19-00004.

Consent to Participate

Participants provided written consents for participation, use and storage of tissue samples.

Consent for Publication

Participants provided written consent explaining protocol and usage of data for publication.

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Robles Espinoza, K., López Uriarte, G.A., García Castañeda, G.B. et al. Multidisciplinary Workup for Stillbirth at a Tertiary-Care Hospital in Northeast Mexico: Findings, Challenges and Perspectives. Matern Child Health J 28, 1072–1079 (2024). https://doi.org/10.1007/s10995-023-03874-3

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