Assessment of 'fresh' versus 'macerated' as accurate markers of time since intrauterine fetal demise in low-income countries
- Resource Type
- Authors
- Henry S. Opare-Addo; Martha E. Boggs; Katherine J. Gold; Richard W. Lieberman; Abdul Razak S. Abdul-Mumin
- Source
- Subject
- Adult
medicine.medical_specialty
Time Factors
Adolescent
Maceration (bone)
Developing country
Ghana
Article
Cohort Studies
Young Adult
Fetus
Pregnancy
Medicine
Humans
Proxy (statistics)
Hospitals, Teaching
Fetal Death
Intrauterine fetal demise
business.industry
Obstetrics
Obstetrics and Gynecology
Reproducibility of Results
General Medicine
Middle Aged
Stillbirth
medicine.disease
Delivery, Obstetric
Time of death
Female
business
Cohort study
- Language
- English
To compare provider assessment of fetal maceration with death-to-delivery interval to evaluate the reliability of appearance as a proxy for time of death.Cohort chart abstraction was performed for all stillbirth deliveries at or above 28 weeks of gestation during a 1-year period in a teaching hospital in Ghana.Of 470 stillborn infants, 337 had adequate data for analysis. Of 47 fetuses alive on admission with death-to-delivery intervals estimated to be less than 8 hours (expected to be reported as fresh), 14 (30%) were actually reported as macerated. Of 94 cases in which the fetus was deceased on admission with death-to-delivery interval of more than 8 hours (expected to be macerated), 17 (18%) were described as fresh.Provider description of fetal appearance may be an unreliable indicator for time since fetal death. The findings have significant implications for stillbirth prevention and assessment.