Importance of Placental Availability When Correlating Clinical and Pathologic Cause of Death in Second and Third Trimester Fetal Deaths
C Pang, M Hernandez, J Tan, S Cerda, CD Sarita-Reyes. Boston Medical Center, Boston, MA
Background: It is known that the majority of second and third trimester fetal deaths are caused by a single or a combination of placental pathologies. This makes the use of placental examination an essential tool when determining fetal cause of death. However, 15 to 20 percent of stillbirths have no identifiable etiology.
Design: A retrospective study of 224 fetal autopsies performed at our Institution (Boston Medical Center) from 2000 to September 2009. Postmortem and placenta histology reports were reviewed. Gestational age, premortem clinical diagnosis, placental diagnosis, postmortem gross and histology findings, and final anatomic diagnosis were recorded.
Results: A total of 224 fetal autopsies were reviewed, of these, 197 (88%) of cases had placentas available for study, and 27 (12%) did not. One hundred and twenty-six (126) (56%) of cases had a placental cause of death (COD) (70% for 2nd trimester (T) and 30% for 3rd trimester (T) deaths).
|Placentas Available||Placental COD||Other COD||No COD|
|Total (224)||197 (88%)||126 (56%)||42 (19%)||57 (25%)|
|2nd T (145)||132 (91%)||102 (70%)||23 (16%)||20 (14%)|
|3rd T (79)||65 (82%)||24 (30%)||19 (24%)||37 (47%)|