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Archives of Gynecology and Obstetrics
Erschienen in: Archives of Gynecology and Obstetrics 2/2011

01.02.2011 | Materno-fetal Medicine

The role of fetal autopsy and placental examination in the causes of fetal death: a retrospective study of 132 cases of stillbirths

verfasst von: L. Reggiani Bonetti, P. Ferrari, N. Trani, L. Maccio, Schirosi Laura, Sartori Giuliana, F. Facchinetti, F. Rivasi

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 2/2011

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Abstract

Purpose

To investigate the most plausible cause of stillbirth by evaluating clinical records and postmortem examination findings including placental analysis.

Methods

A retrospective cohort study concerning 132 stillbirths from 124 pregnancies occurred in the Mother–Infant Department of the University Hospital of Modena, Italy, from January 2000 to December 2004. Collected data were reviewed and classified according to the Gardosi ReCoDe system.

Results

A reasonable cause of fetal death was identified in 99/124 pregnancies (79.84%). No associated relevant factors were disclosed in 25 fetuses (20.16%) classified as unexplained stillbirths. A succeeding scrupulous analysis of the placenta and an accurate clinical record review were useful to detect other conditions in 82 cases, including 5 cases of unexplained stillbirth. The major relevant conditions associated to stillbirths were feto-placental infection especially in the early fetal gestation age, under the 24th week of gestation, and placental insufficiency occurred both in early and late gestation age fetuses and mainly associated with a IUGR (<10th customized percentile). The main frequent secondary conditions were represented by placental anomalies including cluster of avascular villi with stromal fibrosis associated to thrombosis in minor and/or major vessel(s). Through the further analysis of the placenta, we were able to reduce the unexplained stillbirth rate from 20.16 to 15%.

Conclusion

Accurate fetal autopsy and placental examination related to meticulous clinical collecting data are requisites in the valuation of stillbirth and could play an important role in reduction of unexplained stillbirth rate.
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Metadaten
Titel
The role of fetal autopsy and placental examination in the causes of fetal death: a retrospective study of 132 cases of stillbirths
verfasst von
L. Reggiani Bonetti
P. Ferrari
N. Trani
L. Maccio
Schirosi Laura
Sartori Giuliana
F. Facchinetti
F. Rivasi
Publikationsdatum
01.02.2011
Verlag
Springer-Verlag
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 2/2011
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-009-1317-4

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