Clinicopathological evaluation of 59 cases of fetal death
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- Zanconato, G., Piazzola, E., Caloi, E. et al. Arch Gynecol Obstet (2007) 276: 619. doi:10.1007/s00404-007-0391-8
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The purpose of this study has been assessing the determinants of stillbirth among the newborns of the Verona University Obstetrics Department.
Materials and methods
A total of 59 stillbirth cases, observed between January 2000 and June 2006, were retrospectively studied. WHO definition for stillbirth was adopted as the inclusion criterion. Clinical files, feto-maternal laboratory data, feto-placental pathology findings as well as delivery mode and circumstances were all systematically reviewed.
The 59 observed cases correspond to an incidence of 9.8 stillbirths/year, which, considering the institutional delivery rate, correspond to 5.4 cases per 1000 births. Frequent relevant conditions associated with stillbirth were intrauterine growth restriction (15.2%), congenital fetal anomalies (13.5%), various maternal diseases (21.0%); no cause of fetal demise could be found in 10/59 (17.0%) cases, which were classified as unexplained. Most deliveries were successfully induced with prostaglandins except 11 cases (19.0%) which required a C-section due to severe maternal conditions associated with the fetal loss.
Thorough investigation of each individual stillbirth case, by means of an integrated study protocol, along with the Pathologist’s close collaboration, allows identification of a likely cause in the majority of cases. Better knowledge of unexpected fetal loss is the premise for better parental counselling and for prevention of recurrences.