Identification of the causes of intrauterine death during 310 consecutive autopsies

Horn, Lars‐Christian; Langner, Andrea; Stiehl, P; Wittekind, Christian; Faber, R.

doi:10.1016/s0301-2115(03)00371-3

Cited by 88 publications

(60 citation statements)

References 28 publications

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“…12 In this type of placental pathology in pregnancies of 35 weeks or longer, on average, 1 vasculosyncytial membrane per terminal villus was found as compared with, on average, 3 per chorionic villi normally seen. 68 Villous hypomaturity is responsible for 22.5% of intrauterine deaths 69 and has a 70-fold increased risk of associated fetal death, with a 10-fold risk for recurrence, compared with baseline. 70 The fetuses die because of hypoxia, 1 but they can be rescued by earlier delivery.…”

mentioning

confidence: 99%

Hypoxic Patterns of Placental Injury: A Review

Stanek

2013

Archives of Pathology &Amp; Laboratory Medicine

125

126

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Context.—In utero hypoxia is an important cause of perinatal morbidity and mortality and can be evaluated retrospectively to explain perinatal outcomes, to assess recurrence risk in subsequent pregnancies, and to investigate for medicolegal purposes by identification of many hypoxic placental lesions. Definitions of some placental hypoxic lesions have been applied relatively liberally, and many of them are frequently underreported. Objectives.—To present a comprehensive assessment of the criteria for diagnosing acute and chronic histologic features, patterns, and lesions of placental and fetal hypoxia and to discuss clinicopathologic associations and limitations of the use thereof. The significance of lesions that have been described relatively recently and are not yet widely used, such as laminar necrosis; excessive, extravillous trophoblasts; decidual multinucleate extravillous trophoblasts; and, most important, the patterns of diffuse chronic hypoxic preuterine, uterine, and postuterine placental injury and placental maturation defect, will be discussed. Data Sources.—Literature review. Conclusions.—The placenta does not respond in a single way to hypoxia, and various placental hypoxic features should be explained within a clinical context. Because the placenta has a large reserve capacity, hypoxic lesions may not result in poor fetal condition or outcome. On the other hand, very acute, in utero, hypoxic events, followed by prompt delivery, may not be associated with placental pathology, and many poor perinatal outcomes can be explained by an etiology other than hypoxia. Nevertheless, assessment of placental hypoxic lesions is helpful for retrospective explanations of complications in pregnancy and in medicolegal investigation.

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confidence: 99%

Hypoxic Patterns of Placental Injury: A Review

Stanek

2013

Archives of Pathology &Amp; Laboratory Medicine

125

126

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“…'nın (5) 310 ölü doğum olgusundan oluşan serilerinde, olguların %60'ında plasenta ve göbek kordonu patolojileri, %17.1'inde konjenital malformasyon, %2.2'sinde intrauterin infeksiyon, %1.3'ünde travmatik lezyon saptamışlardır. Çalışmamızda yalnızca 98 olgu plasenta ile birlikte gönderildiği için plasenta ve göbek kordonu patolojileri oranı net olarak tespit edilememiştir.…”

Section: Discussionunclassified

“…Otopsi bilgileri ile nüks riskini saptayabilir, sonraki gebelikleri gözetim altında tutarak fetüslere uygun planlar uygulanabilir (4) . Ölü doğumlarda ve neonatal ölümlerde ölüm nedeninin belirlenmesi ailelerde psikolojik iyileşme-yi hızlandırdığı gibi yineleyici riskin tanımlanması açısından da önemlidir (5) . Bu çalışmanın amacı kurumumuzda gerçekleştirilen fetal ve neonatal otopsi bulgularını geriye dönük olarak irdelemektir.…”

Section: Introductionunclassified

Our Results of Fetal and Neonatal Autopsies

Eki̇n¹,

Sayhan²,

Öksüz³

et al. 2015

Behcet Uz Cocuk Hast Derg

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ÖZETAmaç: Kliniğimizde 9 yıllık süredeki fetal ve neonatal otopsilerimizin geriye dönük olarak irdelenmesi Yöntemler: Kliniğimizde 9 yıllık dönemde 216 fetal ve neonatal otopsi olgusu geriye dönük olarak incelenmiştir. Olguların cinsiyet dağılımları, otopsi tanıları ve olgularda saptanan anomalilerin dökümü yapılmıştır. Bulgular: Kliniğimizde yıllık otopsi ortancamız 25'tir. Otopsi tanılarının dağılımı: İlk sırada %55,2 oranında doğumsal anomali saptanmıştır. İkinci sırada %13,3 oranı ile anoksi saptanmış olup, intrakraniyel kanama tanısı %9.2 oranı ile 3. sırada yer almıştır. %8,2 olguda ise otoliz nedeni ile sağlıklı değerlendirme yapılamamıştır. En sık oranda (%35,3) nöral tüp/merkezi sinir sistemi patolojileri saptanmıştır. Bunu %16,6 ile böbrek patolojileri ve %15,3 ile solunum sistem patolojileri izlemektedir. Sonuç: Fetal ve neonatal otopsi ölü doğum, neonatal ölüm veya doğum komplikasyonu sonucu görülen ölümlerin nedenini ve hastalığın yineleme riskini belirlemede ve sonraki gebeliklerin izleminde önemli bir tanı yöntemidir. Anahtar kelimeler: Fetal anomali, otopsi, ölü doğum ABSTRACTObjective: To retrospectively analyse fetal and neonatal autopsies in a period of 9 years in our institution. Methods: In our pathology department 216 fetal and neonatal autopsies performed within 9 years were analysed and documented according to gender distribution, necropsic diagnosis and congenital anomalies. Results: In our institution our median autopsy rate 25. The distribution of autopsy diagnoses was detected as follows: congenital anomalies (55.2%), anoxia (13.3%), intracranial hemorragia (9.2%); while in 8.2% of the cases no spesific diagnosis could be made due to autolysis. The most common pathology was neural tube defects (35.3%) followed by renal pathologies (16.6%) and respiratory system pathologies (15.3%) Conclusion: Perinatal and neonatal autopsies are important procedure for assessing the cause of fetal and neonatal deaths or complications which would help us to regard the risk rate in the consequent pregnancies and lead us in the management of the subsequent pregnancies.

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“…Perinatal death complicates about 1.5% of all births in developed countries. 6 Perinatal mortality rate (PMR) in developing countries is 3 to 5 fold higher than that in the developed countries. The current PMR in India is 49 per 1000.…”

Section: Introductionmentioning

confidence: 99%

“…The current PMR in India is 49 per 1000. 7 6 Various authors worldwide have documented the causes for perinatal mortality. The causes could be antenatal such as maternal diseases like hypertension, diabetes, cardiovascular diseases etc.…”

Section: Introductionmentioning

confidence: 99%