Skip to main content
SpringerLink
Log in

Intrapartum Problems

  • Chapter
  • First Online:
Keeling's Fetal and Neonatal Pathology

  • 1375 Accesses

Abstract

Every year it is estimated that there are approaching 3 million stillbirths, of which 1.2 million are intrapartum. These numbers predominantly reflect the developing world: 98% of these stillbirths occur in the developing world with perinatal mortality rates of up to 150 per 1000 registered births—45% of these are intrapartum. Whereas in the developed world, the rate of hypoxic perinatal death is around 2.5% of the overall perinatal mortality. It is important to recognize that the mortality rate only reflects the tip of the intrapartum morbidity. It is considered that each year around 7 million years worth of disability are due to intrapartum events. It therefore is important to understand the factors in these deaths and reduce not only the intrapartum stillbirth rate but also the considerable morbidity associated with this.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Goldenberg RL, McClure EM, Bhutta ZA, Belizan JM, Reddy UM, Rubens CE, et al. Stillbirths: the vision for 2020. Lancet. 2011;377:1798–805.

    Article  Google Scholar 

  2. Martinez-Biarge M, Diez-Sebastian J, Wusthoff CJ, Mercuri E, Cowan FM. Antepartum and intrapartum factors preceding neonatal hypoxic-ischemic encephalopathy. Pediatrics. 2013;132:e952–9.

    Article  Google Scholar 

  3. Flenady V, Middleton P, Smith GC, Duke W, Erwich JJ, Khong TY, et al. Stillbirths: the way forward in high-income countries. Lancet. 2011;377:1703–17.

    Article  Google Scholar 

  4. Bhutta ZA, Yakoob MY, Lawn JE, Rizvi A, Friberg IK, Weissman E, et al. Stillbirths: what difference can we make and at what cost? Lancet. 2011;377:1523–38.

    Article  Google Scholar 

  5. Li Z, Zeki R, Hilder L, Sullivan EA. Australias’s mothers and babies 2011. AIHW: Canberra; 2013.

    Google Scholar 

  6. Locatelli A, Lambicchi L, Incerti M, Bonati F, Ferdico M, Malguzzi S, et al. Is perinatal asphyxia predictable? BMC Pregnancy Childbirth. 2020;20:186.

    Article  Google Scholar 

  7. Donn SM, Chiswick ML, Fanaroff JM. Medico-legal implications of hypoxic-ischemic birth injury. Sem Fetal Neonat Med. 2014;19:317–21.

    Article  Google Scholar 

  8. Office of National Statistics. http://www.ons.gov.uk/ons/rel/child-health/infant-and-perinatal-mortality-in-england-and-wales-by-social-and-biological-factors/2011/stb-infant-and-perinatal-mortality%2D%2D2011.htmlStatistical. Bulletin: infant and perinatal mortality in England and Wales by Social and Biological Factors, 2011.

  9. CMACE. Centre for Maternal and Child Enquiries (CMACE) Perinatal Mortality 2009: United Kingdom. CMACE: London, 2011. http://www.hqip.org.uk/assets/NCAPOP-Library/CMACE-Reports/35.-March-2011-Perinatal-Mortality-2009.pdf

  10. Darmstadt GL, Yakoob MY, Haws RA, Menezes EV, Soomro T, Bhutta ZA. Reducing stillbirths: interventions during labour. Pregnancy Childbirth. 2009;9(Suppl 1):S6.

    Article  Google Scholar 

  11. Mozooni M, Pennell CE, Preen DB. Healthcare factors associated with the risk of antepartum and intrapartum stillbirth in migrants in Western Australia (2005-2013): a retrospective cohort study. PLoS Med. 2020;17:e1003061.

    Article  Google Scholar 

  12. Ernst LM. A pathologists perspective on the perinatal autopsy. Sem Perinatol. 2015;39:55–63.

    Article  Google Scholar 

  13. Rowe R, Draper ES, Kenyon S, Bevan C, Dickens J, Forrester M, et al. Intrapartum-related perinatal deaths in births planned in midwifery-led settings in Great Britain: findings and recommendations from the ESMiE confidential enquiry. BJOG. 2020;127:1665–75.

    Article  CAS  Google Scholar 

  14. Reed RC. Iatrogenic injury and unexpected hospital death in the newborn. Semin Perinatol. 2015;39:64–9.

    Google Scholar 

  15. Alliance P-SSaND. PSANZ Clinical Practice Guideline for Perinatal Mortality. http://www.psanz.com.au/special-interest/perinatal-mortality-group/psanzcpg

  16. Moshiro R, Mdoe P, Perlman JM. A global view of neonatal asphyxia and resuscitation. Front Pediatr. 2019;7:489.

    Article  Google Scholar 

  17. Herrera-Marschitz M, Neira-Pena T, Rojas-Mancilla E, Espina-Marchant P, Esmar D, Perez R, et al. Perinatal asphyxia: CNS development and deficits with delayed onset. Front Neurosci. 2014;8:47.

    Article  Google Scholar 

  18. Li C, Miao JK, Xu Y, Hua YY, Ma Q, Zhou LL, et al. Prenatal, perinatal and neonatal risk factors for perinatal arterial ischaemic stroke: a systematic review and meta-analysis. Eur J Neurol. 2017;24:1006–15.

    Article  CAS  Google Scholar 

  19. American College of Obstetricians and Gynecologists, Society for Maternal-Fetal Medicine. Obstetric care consensus no. 6: periviable birth. Obstet Gynecol. 2017;130:e187–e99.

    Article  Google Scholar 

  20. Fernandez Arias P, Yoshida K, Brockington IF, Kernreiter J, Klier CM. Foetal abuse. Arch Womens Ment Health. 2019;22:569–73.

    Article  Google Scholar 

  21. Salmaso N, Jablonska B, Scafidi J, Vaccarino FM, Gallo V. Neurobiology of premature brain injury. Nat Neurosci. 2014;17:341–6.

    Article  CAS  Google Scholar 

  22. Azzopardi D, Strohm B, Marlow N, Brocklehurst P, Deierl A, Eddama O, et al. Effects of hypothermia for perinatal asphyxia on childhood outcomes. N Engl J Med. 2014;371:140–9.

    Article  CAS  Google Scholar 

  23. Jacobs SE, Berg M, Hunt R, Tarnow-Mordi WO, Inder TE, Davis PG. Cooling for newborns with hypoxic ischaemic encephalopathy. Cochrane Database Syst Rev. 2013;1:CD003311.

    Google Scholar 

  24. Low JA. Intrapartum fetal asphyxia: definition, diagnosis, and classification. Am J Obstet Gynecol. 1997;176:957–9.

    Article  CAS  Google Scholar 

  25. Rees S, Harding R, Walker D. The biological basis of injury and neuroprotection in the fetal and neonatal brain. Int J Dev Neurosci. 2011;29:551–63.

    Article  Google Scholar 

  26. Storme L, Aubry E, Rakza T, Houeijeh A, Debarge V, Tourneux P, et al. Pathophysiology of persistent pulmonary hypertension of the newborn: impact of the perinatal environment. Arch Cardiovasc Dis. 2013;106:169–77.

    Article  Google Scholar 

  27. Laptook AR. Birth asphyxia and hypoxic-ischemic brain injury in the preterm infant. Clin Perinatol. 2016;43:529–45.

    Article  Google Scholar 

  28. Higgins M, McAuliffe FM, Mooney EE. Clinical associations with a placental diagnosis of delayed villous maturation: a retrospective study. Pediatr Dev Pathol. 2011;14:273–9.

    Article  Google Scholar 

  29. Baergen RN. Cord abnormalities, structural lesions, and cord “accidents”. Semin Diagn Pathol. 2007;24:23–32.

    Article  Google Scholar 

  30. Chan JS, Baergen RN. Gross umbilical cord complications are associated with placental lesions of circulatory stasis and fetal hypoxia. Pediatr Dev Pathol. 2012;15:487–94.

    Article  Google Scholar 

  31. Khong TY. Evidence-based pathology: umbilical cord coiling. Pathology. 2010;42:618–22.

    Article  CAS  Google Scholar 

  32. Baergen RN, Malicki D, Behling C, Benirschke K. Morbidity, mortality, and placental pathology in excessively long umbilical cords: retrospective study. Pediatr Dev Pathol. 2001;4:144–53.

    Article  CAS  Google Scholar 

  33. Gonzalez-Quintero VH, Tolaymat L, Muller AC, Izquierdo L, O'Sullivan MJ, Martin D. Outcomes of pregnancies with sonographically detected nuchal cords remote from delivery. J Ultrasound Med. 2004;23:43–7.

    Article  Google Scholar 

  34. Larson JD, Rayburn WF, Crosby S, Thurnau GR. Multiple nuchal cord entanglements and intrapartum complications. Am J Obstet Gynecol. 1995;173:1228–31.

    Article  CAS  Google Scholar 

  35. Black M, Murphy DJ. Forceps delivery for non-rotational and rotational operative vaginal delivery. Best Pract Res Clin Obstet Gynaecol. 2019;56:55–68.

    Article  Google Scholar 

  36. Baburamani AA, Ek CJ, Walker DW, Castillo-Melendez M. Vulnerability of the developing brain to hypoxic-ischemic damage: contribution of the cerebral vasculature to injury and repair? Front Physiol. 2012;3:424.

    Article  Google Scholar 

  37. Jacques SM, Kupsky WJ, Giorgadze T, Qureshi F. Fetal central nervous system injury in third trimester stillbirth: a clinicopathologic study of 63 cases. Pediatr Dev Pathol. 2012;15:375–84.

    Article  Google Scholar 

  38. Squier W. Acquired damage to the developing brain: timing and causation. 1st ed. New York: Hodder Arnold Publishers; 2002.

    Google Scholar 

  39. Li Y, Gonzalez P, Zhang L. Fetal stress and programming of hypoxic/ischemic-sensitive phenotype in the neonatal brain: mechanisms and possible interventions. Prog Neurobiol. 2012;98:145–65.

    Article  Google Scholar 

  40. Perlman JM. Intrapartum hypoxic-ischemic cerebral injury and subsequent cerebral palsy: medicolegal issues. Pediatrics. 1997;99:851–9.

    Article  CAS  Google Scholar 

  41. Chang KT. Examination of the placenta: medico-legal implications. Semin Fetal Neonatal Med. 2014;19:279–84.

    Google Scholar 

  42. NICE. 2019 surveillance of intrapartum care for healthy women and babies (NICE guideline CG190): National Institute for Health and Care Excellence (UK); 2019 [updated 2019 Feb 27]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK550941/

Download references

Author information

Authors and Affiliations

  1. Department of Pathology, Sidra Medicine, Doha, Qatar

    Adrian K. Charles

Authors
  1. Adrian K. Charles
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Adrian K. Charles .

Editor information

Editors and Affiliations

  1. Pathology, Obstetrics and Gynaecology, University of Adelaide, North Adelaide, SA, Australia

    T. Yee Khong

  2. Histopathology, University Hospitals of Leicester NHS Trust Leicester Royal Infirmary, Leicester, UK

    Roger D. G. Malcomson

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Charles, A.K. (2022). Intrapartum Problems. In: Khong, T.Y., Malcomson, R.D.G. (eds) Keeling's Fetal and Neonatal Pathology. Springer, Cham. https://doi.org/10.1007/978-3-030-84168-3_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-84168-3_16

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-84167-6

  • Online ISBN: 978-3-030-84168-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation