Abstract
Objectives: To know the lesions associated with fetal death in our population. To propose a classification of these lesions, and correlate them with gestational age, birth weight, and presence or absence of maceration. To analyze some characteristics of the lesions associated with fetal mortality. Material and Methods: Population: A total of 1620 fetal autopsies, performed between July 1979 and December 2000, were included. Classification of autopsy results: 1) Satisfactory (S): the observed lesions can explain fetal death (S x AP: only by autopsy; S x AP + CH: by AP plus clinical history; S x AP + K: AP plus karyotype; S x CH: only by clinical history. 2) Poorly satisfactory (PS): the observed lesions cannot explain death. 3) Without diagnosis (WD): without lesions nor clinical history that can explain death. Classification of lesions associated with fetal death: Asphyxia (A); intrauterine infections (IUI); immaturity (I); immune hydrops (IH); developmental anomalies (DA); other (O). Study types: A: autopsy and placental examination; B: external examination of the fetus and placenta; AB: only autopsy. According to birth weight, the patients were classified as ≤ 1000g, 1001 - 1500 g, 1501 - 2500 g, and ≥ 2501 g; according to gestational age (GA), as ≤ 19 weeks (w), 20 - 27 w, 28 - 36 w, and ≥ 36 w. Results: Of the total results, 95.6 % were S, and 94.8 % of these were S x AP. 87.2% were study type A, 4.7 % type B, and 7.6 % type AB. There were 1.1 lesions by fetus; 45 % had A, 23% had DA, 23% had I, 3 % had IUI, 2% had IH, and 4 % had O. The rate of Asphyxia increased with GA and birth weight; 76.2 % was secondary to non-inflammatory placento-annexial diseases, 6.9% was secondary to ovular infections, and 83.3 % of the fetuses were macerated. The most frequent DA were of the nervous and respiratory systems, and more than half of these fetuses were macerated; 80.6% of the immature fetuses had unspecific ovular infections in their placentas. Conclusions: Autopsy is a reliable method to detect lesions associated with fetal death, as well as a useful epidemiological tool for assistance surveillance.
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Fuksman, R., Mazzitelli, N., Grandi, C. et al. Fetal Mortality: Preliminary Results from a Perinatal Pathology Data Base. Pediatr Res 53, 871 (2003). https://doi.org/10.1203/00006450-200305000-00042
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DOI: https://doi.org/10.1203/00006450-200305000-00042