Factores de riesgo de embarazo gemelar que conllevan a la muerte de un gemelo intra útero en embarazos múltiples atendidos en el complejo hospitalario “Alejandro Mann” de la ciudad de Guayaquil en el periodo enero 2016 a diciembre 2020.

Abstract

Background: Every 16 seconds a baby is stillborn (WHO), the risk increases in multiple pregnancy, making diligent prenatal management and control necessary. Lack of access to health services is a fact that causes up to about 200,000 fetal deaths in low / middle income countries. Objective: To determine the risk factors for twin pregnancy that lead to the death of an intrauterine twin in multiple pregnancies attended at the "Alejandro Mann" Hospital Complex in the city of Guayaquil in the period January 2016 to December 2020. Materials and Methods: Observational study, cross-sectional, retrospective of 395 newborns as a result of twin pregnancy; the sample is refined, taking into account: the error in the medical record, a clinical record is used for each twin pregnancy. The analysis of results uses statistical, descriptive measures; for the presentation of data it is done with statistical graphics. Result: There are 7 intra-uterine fetal deaths in twin pregnancies, 65 risk factors were grouped into categories: maternal, placental, obstetric, external, ovular, perinatal. The obstetric factor (68.8%) where the premature rupture of membranes (45.5%) constitutes the risk of notable for fetal death, the maternal factor (18.8%) and maternal anemia (100%) is the second risk found, the risk fetal (12.5%) intra-uterine growth retardation and fetal distress (50%) constitute the third associated risk; fetal death occurred in mothers between 20-34 years of age who reported minimal prenatal control; and the culmination route of pregnancy was caesarean section (71%).