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Perinatal death investigations: What is current practice?

J W Nijkamp1, N J Sebire2, K Bouman3

  • 1Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Seminars in Fetal & Neonatal Medicine
|March 23, 2017
PubMed
Summary
This summary is machine-generated.

Perinatal death (PD) investigation requires a comprehensive approach, including clinical review, placental examination, and fetal autopsy. This aids in understanding causes and recurrence risks for future pregnancies.

Keywords:
AutopsyInvestigationPerinatal deathPlacental histologyPostmortemStillbirth

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Medicine
  • Pathology

Background:

  • Perinatal death (PD) is a significant obstetric complication with profound impact on families.
  • Understanding the cause of PD is crucial for parental grief, recurrence risk assessment, and future pregnancy management.

Purpose of the Study:

  • To outline a systematic diagnostic investigation protocol for perinatal death.
  • To emphasize the importance of integrating clinical and investigative findings for accurate causality determination.

Main Methods:

  • Detailed review of maternal, obstetric, and current pregnancy history.
  • Standard placental examination, molecular cytogenetic evaluation, and fetal autopsy.
  • Kleihauer test for fetal-maternal hemorrhage.
  • Alternative methods for non-consensual autopsies: minimally invasive examination, postmortem MRI, fetal photography.

Main Results:

  • A structured approach to PD investigation yields comprehensive data.
  • Integration of clinical review with placental examination, cytogenetics, and autopsy is essential.
  • Alternative diagnostic methods can be employed when autopsy is not feasible.

Conclusions:

  • A thorough diagnostic investigation is indispensable following a perinatal death.
  • Accurate determination of the cause of death facilitates parental counseling and future reproductive planning.
  • Multifaceted investigation, including clinical assessment and postmortem examinations, is key to understanding PD.