Below, “perinatal period” describes disorders that fall into this category according to ICD-10 (P00-P96). The ICD-10 is used for the International Statistical Classification of Diseases and Related Health Problems and is recognized worldwide.
Certain conditions that originate in the perinatal period
The perinatal period refers to the period from the completed 22nd week of pregnancy (SSW) to the completed 7th day after birth (post partum). In the literature, the beginning of this period is dated differently. Thus, the 24th or 28th week of pregnancy is also mentioned in this context. Pathological conditions may originate during this period, but may not lead to illness or death until later. In addition to infections, pre-eclampsia (high blood pressure during pregnancy) and maternal diabetes mellitus disease that existed before pregnancy or developed during pregnancy (gestational diabetes/pregnancy diabetes) are among the major causes of disease in newborns. It is in the perinatal period that morbidity (incidence of disease) and mortality (morbidity) are highest in a person’s lifetime. Perinatal medicine, which derives from this, focuses on the care of the pregnant woman and the child before and shortly after birth. It primarily includes prenatal diagnosis and therapy, the care of high-risk pregnancies, and the initial care of the newborn. Minimally invasive techniques can be used to treat various fetal clinical pictures intrauterine. The goal of perinatal medicine is to prevent deaths in pregnancy, during or after birth, as well as to reduce the number of birth-injured infants.
“Certain conditions originating in the perinatal period” can be classified into the following groups according to ICD-10:
- Damage to the fetus and newborn caused by maternal factors and by complications of pregnancy, labor, and delivery (ICD-10: P00-P04)
- Disorders associated with duration of pregnancy and fetal growth (ICD-10: P05-P08).
- Birth trauma (ICD-10: P10-P15).
- Diseases of the respiratory and cardiovascular systems specific to the perinatal period (ICD-10: P20-P29).
- Infections specific to the perinatal period (ICD-10: P35-P39).
- Hemorrhagic and hematologic diseases of the fetus and newborn (ICD-10: P50-P61).
- Transitory endocrine and metabolic disorders specific to the fetus and newborn (ICD-10: P70-P74).
- Diseases of the digestive system in the fetus and newborn (ICD-10: P75-P78).
- Disease states involving the skin and temperature regulation in the fetus and newborn (ICD-10: P80-P83).
- Other disorders originating in the perinatal period (ICD-10: P90-P96).
“Certain conditions originating in the perinatal period” can lead to the following problems:
- Complications of prematurity
- Complications during childbirth
- Meningitis (meningitis)
- Neonatal sepsis (neonatal sepsis/blood poisoning of the newborn).
Major risk factors for “Certain conditions originating in the perinatal period”
Behavioral causes
- Nutrition
- Hypercaloric and unhealthy diet (too many carbohydrates (mono- and disaccharides/simple and double sugars), high-fat diet, low in complex carbohydrates and fiber)
- Micronutrient deficiency
- Consumption of stimulants
- Alcohol consumption
- Tobacco consumption
- Drug use
- Lack of exercise
- Psycho-social situation
- Chronic stress
- Young first-time mothers (< 18 years of age) or late mothers (as the mother’s age increases (> 35 years of age), the likelihood of a chromosomal abnormality in the child increases)
- Multiple pregnancies
- Obesity
Causes related to disease
- Maternal pre-existing conditions:
- Obesity
- Cytomegalovirus (HCMV; also human herpes virus 5 (HHV 5))
- Diabetes mellitus – diabetes mellitus type 1, diabetes mellitus type 2
- Coagulation disorders (bleeding / thrombosis tendency).
- HIV
- Hypertension (high blood pressure)
- Renal insufficiency (kidney weakness)
- Thyroid disease with inadequate medication.
- Condition after uterine surgery
- Problems with previous pregnancies:
- Abortion (miscarriage)
- Premature birth
- Complications of previous births (e.g., cesarean section, vacuum, forceps).
- Rh incompatibility
- Premature labor
- Problems caused by or in the course of pregnancy:
- Bleeding
- Cervical insufficiency (weakness of the cervix)
- Gestational diabetes (gestational diabetes)
- Multiple pregnancy
- Placenta previa (the placenta is located in front of the internal cervix).
- Transverse or breech presentation of the child
- Changes in the amount of amniotic fluid (too much or too little).
- Delayed growth of the child or too large child in relation to the week of pregnancy.
Medication
- Active substances can be embryotoxic, that is, harm the unborn child – intake must always be in consultation with the doctor
X-rays
- Radiation therapy (radiotherapy, radiatio)
Please note that the enumeration is only an extract of the possible risk factors. Further causes can be found under the respective disease.
The main diagnostic measures for “Certain conditions originating in the perinatal period”
Prenatal diagnostics (examinations of the unborn child in the womb (prenatal = before birth)).
- Amniocentesis (amniotic fluid collection by puncture of the amniotic cavity).
- Chorionic villus sampling (tissue collection from the fetal (child) portion of the placenta).
- DNA test (blood test for trisomy 21, 18, 13, etc. from the mother’s blood).
- First trimester screening (measurement of nuchal translucency (NT)) – allows to determine the individual risk of disease for fetal trisomies 21, 18 and 13 in combination with biochemical serum parameters.
- Fetal blood collection – ultrasound-guided collection of fetal blood from the umbilical vein or fetal heart.
- Fetal echocardiography – ultrasound examination of the fetal (child) heart during pregnancy.
- Fetal ultrasound diagnostics (malformation diagnostics, growth monitoring).
- Fetoscopy – endoscopic examination of the unborn child; is now performed only in exceptional cases.
- Cordocentesis (puncture of the umbilical cord) – preferably at the placental attachment site.
- Placental puncture (puncture of the placenta).
Which doctor will help you?
For conditions that originate in the perinatal period, the gynecologist or physicians specially trained in perinatal medicine (prenatal diagnosis), neonatologists (deal with typical diseases of newborns and the treatment of premature babies) or pediatric infectiologists are the people to contact.