The placenta in intrauterine demise

Area of Science:

• Perinatal pathology
• Forensic placental examination

Background:

• Placental findings in intrauterine demise can mimic antemortem (before death) pathological processes.
• Accurate differentiation is crucial for determining the cause and timing of fetal death.

Purpose of the Study:

• To provide a comprehensive overview of postmortem placental changes.
• To establish an algorithm for distinguishing ante- versus postmortem placental pathology.

Main Methods:

• Review of existing literature on placental pathology in intrauterine demise.
• Analysis of characteristic postmortem placental alterations.
• Development of a diagnostic algorithm based on key discriminatory features.

Main Results:

• Identified specific placental changes that occur after fetal death.
• Outlined criteria to differentiate these from changes occurring before fetal demise.
• Presented a structured approach to placental examination in cases of intrauterine fetal demise.

Conclusions:

• Postmortem placental changes share similarities with antemortem pathology, necessitating a systematic approach.
• The proposed algorithm aids in accurately distinguishing between ante- and postmortem placental findings.
• This distinction is vital for accurate perinatal and forensic investigations.