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Fetal Circulation

Fetal Circulation

Fetal circulation is a unique system that facilitates the exchange of gases, nutrients, and waste products between the developing fetus and the mother. This intricate process takes place through a special organ called the placenta.
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...

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The Perinatal Asphyxiated Lamb Model: A Model for Newborn Resuscitation

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The Stillbirth Classification System for the Safe Passage Study.

Theonia K Boyd^1,2, Colleen A Wright^3,4, Hein J Odendaal⁵

¹1 Departments of Pathology, Boston Children's Hospital, Massachusetts, USA.

Pediatric and Developmental Pathology : the Official Journal of the Society for Pediatric Pathology and the Paediatric Pathology Society

|March 23, 2017

Summary

This summary is machine-generated.

The Safe Passage Study developed a user-friendly classification system for stillbirth causes, aiding research into prenatal alcohol and smoking effects. This system offers clear, comparable data for perinatal mortality reviews.

Keywords:

autopsy human fetus placenta prenatal alcohol exposure prenatal cigarette smoking exposure undetermined stillbirth

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Area of Science:

Perinatal Medicine
Obstetrics
Public Health

Background:

Stillbirth remains a significant adverse pregnancy outcome with complex etiologies.
Accurate classification of stillbirth causes is crucial for research and prevention strategies.
Existing classification systems present challenges in consistency and clinical integration.

Purpose of the Study:

To describe the classification system developed by the Prenatal Alcohol in SIDS and Stillbirth (PASS) Research Network for assigning stillbirth causes.
To evaluate the role of prenatal alcohol and/or cigarette smoke exposure in stillbirth within a high-risk cohort.
To compare the PASS classification system with existing methods like INCODE and ReCoDe.

Main Methods:

Prospective, international, multi-institutional study involving 12,000 maternal/fetal dyads.
Classification based on 5
sites of origin
and mechanism subcategories for ultimate cause assignment.
Adjudication included review of clinical records, fetal autopsy, placental findings, and required consensus.

Main Results:

Stillbirth causes were classified as: fetal (26%), placental (53%), external (5%), and undetermined (16%).
Placental causes, often linked to maternal disorders with recurrence risks, accounted for 47% of deaths.
Full agreement between classification systems occurred in 26% of cases, with partial agreement in 42%.

Conclusions:

The PASS classification schema is user-friendly and provides comparable data to existing systems.
Key advantages include simplicity, mechanistic formulation, clinicopathologic integration, and an "undetermined" category.
The system is broadly applicable to perinatal mortality review boards using routinely collected data.