Fetal death in eclampsia: I. Its relation to low gestational age, retarded fetal growth and low birthweight

Of 173 eclamptics admitted to the only public maternity hospital in Cali, Colombia 44 had stillbirths making a rate of 25-4 per cent. Fetuses delivered before 32 weeks had nearly four times the stillbirth rate of those delivered at term. Those weighing less than 1600 g. had stillbirth rates about six times higher than those weighing above 2500 g. An attempt was made to divide the risk conveyed by low birthweight into two components; that which was due to low gestational age, and that which was due to an abnormally low rate of growth during the gestational time available. Deviation of birthweight below that expected for age (retarded fetal growth, RFG) was used as a measure of the latter component. RFG became more common as gestation progressed and was associated with fetal death only in the latter part of gestation and with marginal statistical significance. After 35 weeks, fetuses at or below two standard deviations from Gruenwald's mean weight for gestational age (Gruenwald, 1966) had a fetal death rate five times higher than those at the mean. The risk of fetal (intrauterine) death conveyed by low gestational age has not been definitively explained. Alternative pathophysiological mechanisms are discussed.