Fetal Death

Concept map of definition, causes, epidemiology of pregnancy loss for M3s in the OBGYN clerkship

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Fetal Death por Mind Map: Fetal Death

1. Maternal Causes

1.1. demographic conditions

1.1.1. AMA

1.1.2. poverty

1.1.3. obesity

1.2. infections

1.2.1. parvovirus

1.2.1.1. listeria

1.2.1.1.1. CMV

1.3. exposures/trauma

1.3.1. radiation

1.3.1.1. drugs (MTX)

1.4. medical conditions

1.4.1. immune

1.4.1.1. Rh isoimmunization

1.4.2. autoimmune

1.4.2.1. SLE

1.4.2.1.1. APA syndrome

1.4.3. hormonal

1.4.3.1. DM

1.4.3.1.1. Thyroid

1.4.4. CV/renovascular

1.4.4.1. Chr HTN

1.4.4.1.1. Pre-Eclampsia/Eclampsia

1.4.5. hematologic

1.4.5.1. thrombophilias

2. Fetal Causes

2.1. chromosomal

2.1.1. monosomies

2.1.1.1. 45X

2.1.2. trisomies

2.1.2.1. Tr16

2.1.2.1.1. Tr22

2.1.3. polyploidy

2.1.3.1. triploidy

2.2. genetic

2.2.1. hemoglobinopathy

2.2.1.1. alpha-thalassemia

2.2.2. New node

2.3. congenital anomalies

2.4. infections

3. Definitions

3.1. developmental

3.1.1. embryonic (6-9wks) + pre-embryonic / anembryonic (2-5wks)

3.1.1.1. majority of pregnancy losses (30% of all clinically recognized pregnancies)

3.1.2. fetal (10-40wks)

3.1.2.1. minority of pregnancy losses (5% of all on-going pregnancies are lost after 10wks)

3.2. historical/clinical

3.2.1. abortions (< 20wks)

3.2.1.1. late (>10wks)

3.2.1.2. early (<10wks)

3.2.2. stillbirths (> 20wks)

3.2.2.1. some states use >24wks

3.2.2.2. WHO Classification = >20wks or 500g

4. Obstetric Causes

4.1. Multiple Gestation

4.1.1. TTTS

4.2. Uterus

4.2.1. cervical insufficiency

4.2.2. uterine anomalies

4.2.2.1. septum

4.2.3. uterine rupture

4.3. Placenta

4.3.1. umbilical cord

4.3.1.1. "accident"

4.3.1.2. vasa previa

4.3.1.2.1. velamentous insertion

4.3.1.3. prolapse

4.3.1.4. thrombosis

4.3.2. abnormal placentation

4.3.2.1. poor implantation

4.3.2.2. ectopic

4.3.2.3. dysmaturity/proloned pregnancy

4.3.2.4. abruption

4.3.2.5. fetomaternal hemorrhage

4.3.2.6. insufficiency

5. Epidemiology

5.1. ~6/1000LB

5.2. stable rate over last 20 yrs

5.3. 2x higher in AfrAm

6. New Node

7. zz

8. New node

9. New node