Sinaloa.- In Mexico, during 2018 there were 21,195 fetal deaths, of which 17 thousand 612 occurred before delivery. According to the National Institute of Geography and Statistics (Inegi), 93.9 percent of cases had as the leading cause of stillbirth maternal factors, complications of pregnancy and labor, but also from situations congenital malformations, deformities and abnormalities, with 6.1 percent. Even the statistic points out that stillbirth has a rate in the country of 1.69 deaths per ten thousand inhabitants.
Despite the high figure, this represents a reduction compared to 2017, where the rate was 1.80. The Inegi report “Characteristics of fetal deaths recorded in Mexico during 2018” detail that the federal entities with the highest rates of fetal mortality are the State of Mexico, with 9.8; Guanajuato, with 9.3; and Mexico City, with 9.0. In the case of Sinaloa, the unit places the entity in the group of between 2.6 and 5 deaths per ten thousand inhabitants.
Specialists in prenatal care, gynecology and obstetrics mentioned in interview for THE DEBATE that there are many physical risk factors that can cause a pregnancy to become high risk, until it causes loss. But they also agreed that there are situations related to poverty, education and the development of a country that influence the statistics of foetal deaths. Main risks
According to the characteristics of the deceased fetus, the late deaths, which are those of 28 weeks and more gestation, accounted for the highest number of cases, at 8,370, 39.5 percent. This followed by early deaths, from 12 to 19 weeks, with 5 thousand 345, 25.2%; and the intermediates, which are 20 to 27 weeks, with 7 thousand 471, 35.2 percent. According to the Inegi, in nine cases it was not specified in which week of gestation fetal death occurred. Carlos Guillermo Yac Castro, obsterist gynecologist at Baylor College of Medicine in Houston, Texas, explained in an interview for THE DEBATE that most pregnancies that are terminated, either during the first months or before childbirth, have to do with chromosomal alterations; i.e. issues related to genetics. He explained that there is now a new knowledge known as epigenetics, which has nothing to do with genetic material, but with the tissue or substance inside each cell, and those begin to manifest from life , or not, and may worsen in pregnancy, causing the loss of a fetus. In addition, the specialist added that there are also diseases, such as diabetes, hypertension, infections, which are the ones that have been studied the most and which are treated, even, before pregnancy so that nothing happens to the product during the “Prenatal care makes it possible to notice life-threatening situations of the fetus or the patient, and it’s where high-risk pregnancies are born,” the expert said. However, he pointed out that there are things that are not possible to modify with behaviors or medications that have to do with hereditary issues. Carlos Guillermo Yac Castro, also specialized in Monterrey’s Tecnológico, emphasized that the tendency in fetal medicine is to start doing very early tests, unlike how they are performed now, and apply ultrasonographic or blood studies to treat establish a risk diagnosis, avoiding an unwanted outcome. The Inegi report “Characteristics of fetal deaths recorded in Mexico during 2018” also revealed the situation of mothers at the time of the failed pregnancy. Explains that 84.6 percent of women received prenatal care, compared to 11.4 percent who did not; and 4.0 percent that you did not specify whether or not you received medical care during pregnancy.
In addition, with respect to the expulsion or removal procedure, which applies when the gestational age of the fetus is 22 weeks or more, vaginal delivery is the one that recorded the most cases, with 9047, followed by The C-section, with 3964 cases, and the use of forceps, a surgical instrument , with 85.Among abortions, which applies when the gestational age of the fetus is less than 22 weeks, miscarriage is the most common among stillbirths, with 6582 cases, according to the institution. The data showed that the age groups of women with the highest number of pregnancies that ended the product’s death was 20 to 24 years, at 24.0 percent; 25 to 29, with 22.5 per cent; and 30 to 34, with 17.9 per cent, which together amount to more than 50 per cent of the total. In this regard, specialist Carlos Guillermo Yac Castro added that this age group is more likely to stillbirth or to have children with Down syndrome because it gets more pregnant, and the age of 40 or 50 tend to get less pregnant. Economic and social reflection
Rafael Leobardo Apodaca Rodríguez, physician and director of the Hospital de Ginecopediatría no. 2 in Los Mochis, indicated that the health condition of the mother, even her death, has an impact on the fetus. He explained that when talking about maternal death, there was talk of a serious public health problem, since these kinds of events reflect the socio-economic and cultural development of a country. She stressed that governments have been concerned with reducing and reducing maternal mortality by focusing actions for these vulnerable groups: “If a mother, if a pregnant woman has complications during pregnancy, childbirth or postpartum, they will have an impact on Newborn. It is not the same birth at nine months with a healthy mother as being born at seven months with a mother who is diabetic, hypertensive or developed a disease during pregnancy, such as preeclampsia,” she said. Rafael Leobardo Apodaca Rodríguez added that that is why the importance that institutions have given to prenatal care, but also to the preconception consultation, which means that a woman and her partner, before embarking on a pregnancy, must go to a consultation to proper studies and see reproductive risks: “Pregnancy is unknown as a unmasking, because it can unmask diseases of the mother she did not know she had, such as lupus, diabetes, hypertension, that a woman can develop during pregnancy, because pregnancy is not a disease, but the changes that happen test each of the organs,’ she said. Duels
The doctor further added that the situation also becomes emotional, impacting not only the mother, but also the family group, who are preparing to receive a new member to be born, not to die: “It is a duel that has to be handled with psychol support “Ogicoco”, he said. In medical care, inegi revealed that 68.3 percent of pregnancies that ended in stillbirth were treated by OBCeding physicians; and 25.1 percent for another type of doctor. The midwives were 114 cases. In addition, 2376 women who had a pregnancy that ended in the death of the product reported not being affiliated with health services. This while the health services reporting the largest number of mothers affiliated are The Popular Insurance, with 9904 cases; and THE IMSS, with 5916 cases. In turn, the specialist José Ulises Bojórquez López added in interview for EL DEBATE that even the books do not list an important factor that can lead to stillbirth, such as poverty. He noted that although Popular Insurance offers free health care to all women in gestation, many of them did not attend the consultation, also derived from lack of education. The obsterite gynecologist added that previous abortions, C-sections and drug addictions, which speak of an addicted patient should also be taken into account as a reason for risk. Maternal-child death
Women and newborns are more vulnerable during and immediately after childbirth. An estimated 2.8 million pregnant and newborn women die each year, or one every 11 seconds, mainly from preventable causes, according to new estimates of child and maternal mortality provided by Unicef and the World Health,” further explains that mothers and children survive more than ever the vicissitudes of childbirth and early childhood. Since 2000, child deaths have been reduced by almost half; and maternal deaths by more than a third, mainly due to better access to cheap and quality health services. Despite this, global organizations report that more than 290,000 women died from complications during pregnancy and childbirth in 2017.
Methodological note
The information is obtained from two informing sources: the Officers that make up the National System of the Civil Registry and the Directorate General of Legal and Legislative Studies (panteones) in the City of México.La information that integrates the statistics was 1384 reporting sources.
Original source in Spanish
