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The following research project has the purpose of correlating fetal mortality with the placental destruction presented in a SARS-CoV-2 infection, our objective is to determine the different reasons that can aggravate the destruction of the placenta, in addition to a description of the Pathophysiological mechanisms, such as the ACE2 receptors which once activated by the virus can allow molecular signaling and various mechanisms of action that arise along with different pathways known as inflammasome, RAS and other types of inflammation along with the disease that will cause different consequences that may be the reason for placental hypoperfusion and subsequently fetal death. In patients that are in a gestational period, was explored their clinical history which lead us to determine the possibility of a vertical transmission, in many placental biopsies are indicated symptomatic prevalence related with the patient’s age, a higher prevalence was found in the third week of pregnancy. We consider this type of study is essential due to the lack of current information available, and because it allows to know the consequences about the infection of covid-19 during pregnancy, such as placental degeneration or the possibility of a fetal death. The methodology used was a compilation of several articles obtained by search engines open to the public, and from official sites provided by the Autonomous University of San Luis Potosí., El siguiente trabajo de investigación que se presenta tiene el propósito correlacionar la destrucción placentaria a causa de la afección por SARS-CoV-2 con la mortalidad fetal, determinar las diferentes causas que pueden agravar la destrucción placentaria además de describir los mecanismos fisiopatológicos, como los receptores de ACE2 una vez activados por el virus permiten realizar señaléticas moleculares y mecanismos de acción que suscita junto a diferentes vías conocidas como inflamosoma, RAS y otras vías de inflamación junto a la enfermedad causarán diferentes consecuencias que provocan hipoperfusión placentaria y posteriormente la muerte fetal, en pacientes en periodo gestacional, se exploró y se recopiló historial clínico de complicaciones en otros estudios que determinaban la posibilidad de la transmisión vertical por el virus COVID-19 y diferentes manifestaciones encontradas en biopsias placentarias que indicaban anteriormente prevalencia sintomática junto a la edad del paciente se encontró una mayor prevalencia en la tercera semana de gestación, se considera que este estudio es imprescindible, debido a sus hallazgos junto con la enfermedad covid-19 permiten dar positivo junto con la degeneración de la placenta e indica mayor prevalencia de muerte fetal en gestantes positivas para covid-19, la metodología que se utilizó fue una compilación de varios artículos obtenidos por motores de búsqueda abiertos al público, y de sitios oficiales proporcionados y no proporcionados por la Universidad Autónoma de San Luis Potosí.

Introduction: Lethal congenital anomalies (LCA) are anomalies associated with early stillbirth or newborn death. Currently, there are no data on the incidence of LCAs in Peru.Objectives: To estimate the cumulative incidence of LCAs in Peru, the Department of Lima, and six hospitals located in the city of Lima (Peru), and to describe the characteristics of LCA cases reported between 2012 and 2016 at Instituto Nacional Materno Perinatal (INMP), located in Lima, Perú.Materials and methods: Cumulative incidence of LCAs in Peru was determined based on the cases reported in a five-year period, which varied depending on data accessibility (2011-2015 and 2012-2016). In addition, the medical records of neonates with LCA registered at INMP were reviewed to identify the characteristics of these cases.Results: Cumulative incidence of LCAs in Peru was 0.89 cases per 10 000 newborns, while at INMP it was 7.19 cases. Out of 48 newborns with LCAs treated at INMP during the study period, 54.2 % were born with neonatal depression, and 83.3% died during their hospital stay.Conclusion: Cumulative incidences of LCAs reported here (Lima, Department of Lima, and Peru) were lower than those described by international epidemiological surveillance systems, which might be caused due to shortcomings related to the registration of these cases in the health institutions and records analyzed here., Introducción. Las anomalías fetales incompatibles con la vida (AFIV) son aquellas que se asocian con la muerte temprana del feto o del recién nacido. En la actualidad, se desconoce la magnitud de este problema en Perú.Objetivos. Estimar la incidencia acumulada de AFIV en Perú, en el departamento de Lima y en seis hospitales de la ciudad de Lima, y describir las características de este tipo de anomalías reportadas entre 2012 y 2016 en el Instituto Nacional Materno Perinatal (INMP) de Lima, Perú.Materiales y métodos. Se determinó la incidencia acumulada de las AFIV reportadas en un período de cinco años en Perú, el cual varió dependiendo de la disponibilidad de los datos (2011-2015 y 2012-2016). Además, se revisaron las historias clínicas de los neonatos con AFIV registradas en el INMP para obtener sus características.Resultados. La incidencia acumulada de AFIV en todo el Perú fue de 0.89 por cada 10 000 recién nacidos y en el INMP fue 7.19. De los 48 recién nacidos con AFIV atendidos en el INMP, 54.2% nacieron con depresión neonatal y 83.3% fallecieron en el hospital.Conclusión. Las incidencias acumuladas de AFIV encontradas fueron menores a las reportadas por los sistemas internacionales de vigilancia epidemiológica, lo que podría deberse a falencias en su registro en las instituciones de salud y registros analizados.

Introduction: Lethal congenital anomalies (LCA) are anomalies associated with early stillbirth or newborn death. Currently, there are no data on the incidence of LCAs in Peru. Objectives: To estimate the cumulative incidence of LCAs in Peru, the Department of Lima, and six hospitals located in the city of Lima (Peru), and to describe the characteristics of LCA cases reported between 2012 and 2016 at Instituto Nacional Materno Perinatal (INMP), located in Lima, Perú. Materials and methods: Cumulative incidence of LCAs in Peru was determined based on the cases reported in a five-year period, which varied depending on data accessibility (2011-2015 and 2012-2016). In addition, the medical records of neonates with LCA registered at INMP were reviewed to identify the characteristics of these cases. Results: Cumulative incidence of LCAs in Peru was 0.89 cases per 10 000 newborns, while at INMP it was 7.19 cases. Out of 48 newborns with LCAs treated at INMP during the study period, 54.2 % were born with neonatal depression, and 83.3% died during their hospital stay. Conclusion: Cumulative incidences of LCAs reported here (Lima, Department of Lima, and Peru) were lower than those described by international epidemiological surveillance systems, which might be caused due to shortcomings related to the registration of these cases in the health institutions and records analyzed here., Introducción. Las anomalías fetales incompatibles con la vida (AFIV) son aquellas que se asocian con la muerte temprana del feto o del recién nacido. En la actualidad, se desconoce la magnitud de este problema en Perú. Objetivos. Estimar la incidencia acumulada de AFIV en Perú, en el departamento de Lima y en seis hospitales de la ciudad de Lima, y describir las características de este tipo de anomalías reportadas entre 2012 y 2016 en el Instituto Nacional Materno Perinatal (INMP) de Lima, Perú. Materiales y métodos. Se determinó la incidencia acumulada de las AFIV reportadas en un período de cinco años en Perú, el cual varió dependiendo de la disponibilidad de los datos (2011-2015 y 2012-2016). Además, se revisaron las historias clínicas de los neonatos con AFIV registradas en el INMP para obtener sus características. Resultados. La incidencia acumulada de AFIV en todo el Perú fue de 0.89 por cada 10 000 recién nacidos y en el INMP fue 7.19. De los 48 recién nacidos con AFIV atendidos en el INMP, 54.2% nacieron con depresión neonatal y 83.3% fallecieron en el hospital. Conclusión. Las incidencias acumuladas de AFIV encontradas fueron menores a las reportadas por los sistemas internacionales de vigilancia epidemiológica, lo que podría deberse a falencias en su registro en las instituciones de salud y registros analizados.

Intrahepatic cholestasis of pregnancy is the most common pregnancy-specific liver disease and typically occurs during the second trimester or third trimester of pregnancy. It has a multifactorial etiology, which will depend on genetic characteristics and hormonal influences, among other variables. It is characterized by pruritus and alterations of laboratory parameters, such as elevation of bile acids and alteration of liver function tests. It is still poorly understood and because the guidelines have not yet been standardized, it has different diagnostic criteria. The treatment pillar consists of ursodeoxycholic acid. It is usually benign for women with rapid resolution after childbirth, but is associated with adverse perinatal complications, including preterm birth and intrauterine fetal death. There is still much to explore and determine regarding this complex pathology, in order to reach a consensus among the different guides and to obtain the best recommendations for the population worldwide., La colestasis intrahepática del embarazo es la enfermedad hepática específica del embarazo más común, y se presenta típicamente durante el segundo trimestre tardío o tercer trimestre del embarazo. Tiene una etiología multifactorial, que dependerá de características genéticas e influencias hormonales entre otras variables. Se caracteriza por prurito y alteraciones a nivel de parámetros de laboratorio, tales como elevación de ácidos biliares y alteración de pruebas de función hepática. Aún es poco comprendida, y debido a que no se han estandarizado las guías, cuenta con distintos criterios diagnósticos. El pilar del tratamiento consiste en el ácido ursodesoxicólico. Suele ser benigna para la mujer con una rápida resolución posterior al parto, pero está asociada a complicaciones adversas perinatales, entre ellas el parto pretérmino y la muerte fetal intrauterina. Aún queda mucho por explorar y determinar respecto a esta patología de carácter complejo, para lograr alcanzar un consenso entre las distintas guías y conseguir las mejores recomendaciones para la población a escala mundial.

Purpose: While a variety of factors may play a role in fetal and neonatal deaths, postmaturity as a cause of stillbirth remains a topic of debate. It still is unclear, whether induction of labor at a particular gestational age may prevent fetal deaths. Methods: A multidisciplinary working group was granted access to the most recent set of relevant German routine perinatal data, comprising all 5,291,011 hospital births from 2005 to 2012. We analyzed correlations in rates of induction of labor (IOL), perinatal mortality (in particular stillbirths) at different gestational ages, and fetal morbidity. Correlations were tested with Pearson's product-moment analysis (α = 5 %). All computations were performed with SPSS version 22. Results: Induction rates rose significantly from 16.5 to 21.9 % (r = 0.98; p \ 0.001). There were no significant changes in stillbirth rates (0.28-0.35 per 100 births; r = 0.045; p = 0.806). Stillbirth rates 2009-2012 remained stable in all gestational age groups irrespective of induction. Fetal morbidity (one or more ICD-10 codes) rose significantly during 2005–2012. This was true for both children with (from 33 to 37 %, r = 0.784, p \ 0.001) and without (from 25 to 31 %, (r = 0.920, p \ 0.001) IOL. Conclusions: An increase in IOL at term is not associated with a decline in perinatal mortality. Perinatal morbidity increased with and without indiction of labor.

An estimated 11%-20% of clinically recognized pregnancies result in spontaneous abortion. The literature finds elevated risk of spontaneous abortion among women who report adverse financial life events. This work suggests that, at the population level, national economic decline-an ambient and plausibly unexpected stressor-will precede an increase in spontaneous abortion. We tested this hypothesis using high-quality information on pregnancy and spontaneous loss for all women in Denmark. We applied time-series methods to monthly counts of clinically detected spontaneous abortions (n = 157,449) and the unemployment rate in Denmark beginning in January 1995 and ending in December 2009. Our statistical methods controlled for temporal patterns in spontaneous abortion (e.g., seasonality, trend) and changes in the population of pregnancies at risk of loss. Unexpected increases in the unemployment rate preceded by 1 month a rise in the number of spontaneous abortions (β = 33.19 losses/month, 95% confidence interval: 8.71, 57.67). An attendant analysis that used consumption of durable household goods as an indicator of financial insecurity supported the inference from our main test. Changes over time in elective abortions and in the cohort composition of high-risk pregnancies did not account for results. It appears that in Denmark, ambient stressors as common as increasing unemployment may precede a population-level increase in spontaneous abortion.

Introduction: During 2012, 13% of the deaths worldwide in children under the age of 28 days were due to congenital malformations. In Colombia, congenital malformations are the second leading cause of infant mortality. Objective: To determine the geographical distribution of extended perinatal mortality due to congenital malformations in Colombia between 1999 and 2008. Materials and methods: We conducted a cross-sectional study. We revised all death certificates issued between 1999 and 2008. We defined perinatal mortality as fetal or non-fetal deaths within the first 28 days after delivery in children with body weight ≥500 grams, and congenital malformations according to ICD-10 diagnostic codes Q000 - Q999. The annual birth projection was used as the denominator. We defined high mortality areas due to congenital malformations as those in the 90th percentile. Results: We recorded 22,361 perinatal deaths due to congenital malformations. The following provinces exceeded the 90th perinatal mortality percentile: Antioquia, Caldas, Risaralda, Huila, Quindío, Bogotá, Valle del Cauca and Guainía. Among the municipalities, the highest perinatal mortality rates were found in Giraldo, Ciudad Bolívar, Riosucio, Liborina, Supía, Alejandría, Sopetrán, San Jerónimo, Santa Fe de Antioquia and Marmato (205.81 and 74.18 per 10.000 live births).The perinatal mortality rate due to malformations of the circulatory system was 28.1 per 10.000 live births, whereas the rates for central nervous system defects and chromosomal abnormalities were 13.7 and 7.0, respectively. Conclusions: The Andean region showed high perinatal mortality rates due to congenital malformations. There is an urgent need to identify possible risk factors of perinatal mortality and implement successive prevention programs in that particular region., Introducción. Durante 2012, las anomalías congénitas fueron la causa de 13 % de las muertes en menores de 28 días a nivel mundial y, en Colombia constituyeron la segunda causa de mortalidad infantil. Objetivo. Determinar la distribución geográfica de la mortalidad perinatal por anomalías congénitas en Colombia entre 1999 y 2008. Materiales y métodos. Se hizo un estudio descriptivo revisando los certificados de defunción de Colombia. La muerte perinatal se definió como muerte fetal y no fetal en niños con un peso de 500 g o más y 28 o menos días de edad, y las anomalías congénitas, como causa básica de la muerte (Clasificación Internacional de Enfermedades - CIE10: Q000 a Q999). La proyección nacional de nacimientos se tomó como el denominador de las tasas específicas. Se calcularon los percentiles para analizar las áreas de alta mortalidad (percentil de 90 o más). Resultados. Se encontraron 22.361 muertes perinatales por anomalías congénitas. Antioquia, Caldas, Risaralda, Huila, Quindío, Bogotá, Valle del Cauca y Guainía superaron, en promedio, el percentil 90 durante los diez años de estudio. Los municipios con mayores tasas de mortalidad fueron: Giraldo, Ciudad Bolívar, Riosucio, Liborina, Supía, Alejandría, Sopetrán, San Jerónimo, Santa Fe de Antioquia y Marmato, en donde oscilaron entre 205,81 y 74,18 por 10.000 nacimientos. Las tasas de mortalidad perinatal por 10.000 nacidos vivos fueron de 28,1 para el grupo de malformaciones del sistema circulatorio; de 13,7 para anomalías del sistema nervioso central, y de 7,0 para anomalías cromosómicas. Conclusión. La alta mortalidad perinatal por anomalías congénitas en la región andina requiere acciones urgentes de investigación sobre los posibles riesgos y medidas de prevención.

BACKGROUND: Variation in birth registration criteria may compromise international comparisons of fetal and infant mortality. We examined the effect of birth registration practices on fetal and infant mortality rates to determine whether observed differences in perinatal and infant mortality rates were artifacts of birth registration or reflected true differences in health status.METHODS: A retrospective population-based cohort study was done using data from Canada, United States, Denmark, Finland, Iceland, Norway, and Sweden from 1995-2005. Main outcome measures included live births by gestational age and birth weight; gestational age-and birth weight-specific stillbirth rates; neonatal, post-neonatal, and cause-specific infant mortality.RESULTS: Proportion of live births <22 weeks varied substantially: Sweden (not reported), Iceland (0.00%), Finland (0.001%), Denmark (0.01%), Norway (0.02%), Canada (0.07%) and United States (0.08%). At 22-23 weeks, neonatal mortality rates were highest in Canada (892.2 per 1000 live births), Denmark (879.3) and Iceland (1000.0), moderately high in the United States (724.1), Finland (794.3) and Norway (739.0) and low in Sweden (561.2). Stillbirth:live birth ratios at 22-23 weeks were significantly lower in the United States (79.2 stillbirths per 100 live births) and Finland (90.8) than in Canada (112.1), Iceland (176.2) and Norway (173.9). Crude neonatal mortality rates were 83% higher in Canada and 96% higher in the United States than Finland. Neonatal mortality rates among live births ≥ 28 weeks were lower in Canada and United States compared with Finland. Post-neonatal mortality rates were higher in Canada and United States than in Nordic countries.CONCLUSIONS: Live birth frequencies and stillbirth and neonatal mortality patterns at the borderline of viability are likely due to differences in birth registration practices, although true differences in maternal, fetal and infant health cannot be ruled out

OBJECTIVE: To evaluate whether climate change is associated with male:female ratios (sex ratios) of fetal deaths and births in Japan.DESIGN: A population-based cohort study.SETTING: Not applicable.PATIENT(S): Newborn infants and fetuses spontaneously aborted after 12 weeks of gestation.INTERVENTION(S): None.MAIN OUTCOME MEASURE(S): Yearly sex ratios of fetal deaths and newborn infants and monthly fetal death rates and sex ratios of newborn infants.RESULT(S): A statistically significant positive association was found between yearly temperature differences and sex ratios of fetal deaths; a statistically significant negative association was found between temperature differences and sex ratios of newborn infants from 1968 to 2012, and between sex ratios of births and of fetal deaths. The sex ratios of fetal deaths have been increasing steadily along with temperature differences, whereas the sex ratios of newborn infants have been decreasing since the 1970s. Two climate extremes, a very hot summer in 2010 and a very cold winter in January 2011, showed not only statistically significant declines in sex ratios of newborn infants 9 months later in June 2011 and October 2011 but also statistically significant increases of fetal death rates immediately, in September 2010 and January 2011.CONCLUSION(S): The recent temperature fluctuations in Japan seem to be linked to a lower male:female sex ratio of newborn infants, partly via increased male fetal deaths. Male concepti seem to be especially vulnerable to external stress factors, including climate changes.

Doel. Vergelijking van de perinatale sterfte in Nederland met die in andere Europese landen (Peristat-II) en met gegevens van vijf jaar eerder (Peristat-I). Opzet. Beschrijvend onderzoek. Methode. Indicatoren voor perinatale sterfte die ontwikkeld waren voor Peristat-I werden in Peristat-II opnieuw gebruikt. Gegevens over perinatale sterfte in het jaar 2004 werden aangeleverd door 26 Europese landen. De Nederlandse gegevens waren afkomstig uit de Landelijke Verloskunde Registratie van verloskundigen en gynaecologen en uit de Landelijke Neonatologie Registratie. Resultaten. In Peristat-I had Nederland vanaf 22 weken zwangerschapsduur het hoogste foetale sterftecijfer (7,4 per 1000 in totaal geborenen). Op Griekenland na had Nederland bovendien het hoogste vroege neonatale sterftecijfer (3,5 per 1000 levendgeborenen). In Peristat-II heeft Nederland vanaf 22 weken zwangerschapsduur na Frankrijk het hoogste foetale sterftecijfer (7,0 per 1000 in totaal geborenen). Van alle West-Europese landen heeft Nederland het hoogste vroege neonatale sterftecijfer (3,0 per 1000 levendgeborenen). De Nederlandse perinatale sterfte is in 5 jaar afgenomen van 10,9 naar 10,0 per 1000 in totaal geborenen, maar de afname is sneller in andere landen. Conclusie. Nederland heeft relatief veel oudere moeders en meerlingzwangerschappen, maar dit kan slechts een deel van de hoge perinatale sterfte verklaren. De Nederlandse perinatale sterfte neemt nog steeds een ongunstige positie in de Europese rangorde in. Er is meer onderzoek nodig om inzicht te krijgen in de Nederlandse prevalentie van risicofactoren voor perinatale sterfte ten opzichte van andere Europese landen. Daarnaast verdienen de perinatale gezondheid en de kwaliteit van de perinatale gezondheidszorg een prominentere plaats in Nederlandse onderzoeksprogramma’s.