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Intrauterin fosterdød

Sist revidert:
Sist revidert av:


Definisjon:
Tap av graviditet etter 22. svangerskapsuke. Årsaken er forhold ved fosteret eller moren. Kromosomfeil er antatt å være forklaringen hos ca. 25%. I 20-30% av tilfellene finner man ingen årsak.
Forekomst:
Dødfødsel forekommer i 0,3%-0,4% av graviditeter.
Symptomer:
Manglende fosterbevegelser og manglende tilvekst
Funn:
Diagnosen stilles sikkert ved ultralyd
Diagnostikk:
Etter dødfødsel anbefales obduksjon av barnet, og utredning av mor for om mulig å finne en forklaring på hendelsen.
Behandling:
Grundig informasjon og oppfølging, ev. psykoterapi.
  1. Helgadottir LB, Turowski G, Tveit JH, et al. Intrauterin fosterdød, dødfødsel, utredning. Veileder i fødselshjelp 2020. Norsk gynekologisk forening. www.legeforeningen.no  
  2. Michels TC, Tiu AY. Second trimester pregnancy loss. Am Fam Physician 2007; 76: 1341-6. PubMed  
  3. Helgadottir LB, Skjeldestad FE, Jacobsen AF, Sandset PM, Jacobsen EM. Incidence and risk factors of fetal death in Norway: a case-control study. Acta Obstet Gynecol Scand 2011; 90(4):390-397. PubMed  
  4. Folkehelseinstituttet. Medisinsk fødselsregister - statistikkbank. F2b-6: Dødfødte iht Euro-Peristat (fødte f.o.m. 22 uker); 2018. Siden besøkt 09.07.19 statistikkbank.fhi.no  
  5. Vik E, Aasheim V, Schytt E et al. Stillbirth in relation to maternal country of birth and other migration related factors: a population-based study in Norway. BMC Pregnancy Childbirth 2019; 19: epub. pmid:30611227 PubMed  
  6. Flenady V, Koopmans L, Middleton P, et al. Major risk factors for stillbirth in high income countries: a systematic review and meta-analysis. Lancet 2011; 377: 1331-40. PubMed  
  7. Reinebrant HE, et al. Making stillbirths visible: a systematic review of globally reported causes of stillbirth. BJOG 2018;125.2 212-24. PMID: 29193794 PubMed  
  8. Menasha J, Levy B, Hirschhorn K, Kardon NB. Incidence and spectrum of chromosome abnormalities in spontaneous abortions: new insights from a 12-year study. Genet Med. 2005;7(4):251–263. doi: 10.1097/01.GIM.0000160075.96707.04 DOI  
  9. Lichter KE, Sheffield J, Graham EM, Eke AC. Adjuvant 17-hydroxyprogesterone caproate in women withultrasound-indicated cerclage: a systematic review and meta-analysis. J Matern Fetal Neonatal Med 2020; 33:3177. PubMed  
  10. Lockwood CJ, Bauer KA. Inherited thrombophilias in pregnancy. UpToDate, last updated Oct 15, 2021. UpToDate  
  11. Yelnik CM, Laskin CA, Porter TF, et al. Lupus anticoagulant is the main predictor of adverse pregnancy outcomes in aPL-positive patients: validation of PROMISSE study results. Lupus Sci Med 2016; 3:e000131.
  12. Empson M, Lassere M, Craig J, Scott J. Prevention of recurrent miscarriage for women with antiphospholipid antibody syndrome or lupus anticoagulant. Cochrane Database Syst Rev, issue 2, 2005. The Cochrane Library  
  13. Leitich H, Kiss H. Asymptomatic bacterial vaginosis and intermediate flora as risk factors for adverse pregnancy outcome. Best Pract Res Clin Obstet Gynaecol 2007; 21:375. PubMed  
  14. Brocklehurst P, Gordon A, Heatley E, Milan SJ. Antibiotics for treating bacterial vaginosis in pregnancy. Cochrane Database of Systematic Reviews 2013, Issue 1. Art. No.: CD000262. DOI: 10.1002/14651858.CD000262.pub4. DOI  
  15. Page JM, Bardsley T, Thorsten V, et al. Stillbirth associated with infection in a diverse U.S. cohort. Obstet Gynecol 2019; 134: 1187. pmid:31764728 PubMed  
  16. Ornoy A, Ergaz Z. Parvovirus B19 infection during pregnancy and risks to the fetus. Birth Defects Res. 2017;109(5):311-323. PubMed  
  17. Reddy UM, Laughon SK, Sun L, et al. Prepregnancy risk factors for antepartum stillbirth in the United States. Obstet Gynecol 2010; 116: 1119-26. PubMed  
  18. Wong K, Carson KR, Crane J. Risk of stillbirth in singleton gestations following in vitro methods of conception: a systematic review and meta-analysis. BJOG. 2021 Mar 8. Epub ahead of print. PMID: 33683788. PubMed  
  19. Lamont K, Scott NW, Jones GT, Bhattacharya S. Risk of recurrent stillbirth: systematic review and meta-analysis. BMJ 2015; 350: h3080. doi:10.1136/bmj.h3080 DOI  
  20. Koopmans L, Wilson T, Cacciatore J, Flenady V. Support for mothers, fathers and families after perinatal death. Cochrane Database of Systematic Reviews 2013, Issue 6. Art. No.: CD000452. DOI: 10.1002/14651858.CD000452.pub3. DOI  
  21. Regan AK, Gissler M, Magnus MC et al. Association between interpregnancy interval and adverse birth outcomes in women with a previous stillbirth: an international cohort study. Lancet 2019; S0140-6736: 32266-9. pmid:30827781 PubMed  
  22. Wang X, Chen C, Wang L, Chen D, Guang W, French J. Conception, early pregnancy loss, and time to clinical pregnancy: a population-based prospective study. Fertil Steril 2003; 79: 577-84. PubMed  
  • Ingard Løge, spesialist allmennmedisin, redaktør NEL