Classification of stillbirths is an ongoing dilemma
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Luigi Nappi
, Gloria Bonaccorsi
Abstract
Aim:
To compare different classification systems in a cohort of stillbirths undergoing a comprehensive workup; to establish whether a particular classification system is most suitable and useful in determining cause of death, purporting the lowest percentage of unexplained death.
Methods:
Cases of stillbirth at gestational age 22–41 weeks occurring at the Department of Gynecology and Obstetrics of Foggia University during a 4 year period were collected. The World Health Organization (WHO) diagnosis of stillbirth was used. All the data collection was based on the recommendations of an Italian diagnostic workup for stillbirth. Two expert obstetricians reviewed all cases and classified causes according to five classification systems.
Results:
Relevant Condition at Death (ReCoDe) and Causes Of Death and Associated Conditions (CODAC) classification systems performed best in retaining information. The ReCoDe system provided the lowest rate of unexplained stillbirth (14%) compared to de Galan-Roosen (16%), CODAC (16%), Tulip (18%), Wigglesworth (62%).
Conclusion:
Classification of stillbirth is influenced by the multiplicity of possible causes and factors related to fetal death. Fetal autopsy, placental histology and cytogenetic analysis are strongly recommended to have a complete diagnostic evaluation. Commonly employed classification systems performed differently in our experience, the most satisfactory being the ReCoDe. Given the rate of “unexplained” cases, none can be considered optimal and further efforts are necessary to work out a clinically useful system.
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The authors stated that there are no conflicts of interest regarding the publication of this article.
©2016 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Editorials
- Editorial
- First 10 years of the International Academy of Perinatal Medicine – which lessons we have learned and what are future challenges
- Recommendation and Guidelines for Perinatal Practice
- Is intrauterine surgery justified? Report from the working group on ultrasound in obstetrics of the World Association of Perinatal Medicine (WAPM)
- Original articles - Obstetrics
- Examiner’s finger-mounted fetal tissue oximetry: a preliminary report on 30 cases
- Values of T/QRS ratio in pregnancies complicated by intrauterine growth restriction
- Cesarean delivery among women with prolonged labor induction
- Maternal and fetal outcomes after uterine fundal pressure in spontaneous and assisted vaginal deliveries
- Impact of maternal age on delivery outcomes following spontaneous labour at term
- Maternal characteristics of pregnancies with intrauterine fetal demise
- Evaluation of standardized, computerized Dawes/Redman heart-rate analysis based on different recording methods and in relation to fetal beat-to-beat heart rate variability
- Perinatal outcomes with isolated oligohydramnios at term pregnancy
- Factors associated with choice of delivery with or without epidural analgesia among laboring women: a cross-sectional survey at a tertiary care hospital of a developing country
- Ultrasonographic assessment of cervical length in pregnancies scheduled for a cesarean delivery: prediction of early spontaneous onset of labor
- Characterization of visceral and subcutaneous adipose tissue transcriptome in pregnant women with and without spontaneous labor at term: implication of alternative splicing in the metabolic adaptations of adipose tissue to parturition
- Classification of stillbirths is an ongoing dilemma
- Out-of-hospital births in the United States 2009–2014
- Congress Calendar
- Congress Calendar
Artikel in diesem Heft
- Frontmatter
- Editorials
- Editorial
- First 10 years of the International Academy of Perinatal Medicine – which lessons we have learned and what are future challenges
- Recommendation and Guidelines for Perinatal Practice
- Is intrauterine surgery justified? Report from the working group on ultrasound in obstetrics of the World Association of Perinatal Medicine (WAPM)
- Original articles - Obstetrics
- Examiner’s finger-mounted fetal tissue oximetry: a preliminary report on 30 cases
- Values of T/QRS ratio in pregnancies complicated by intrauterine growth restriction
- Cesarean delivery among women with prolonged labor induction
- Maternal and fetal outcomes after uterine fundal pressure in spontaneous and assisted vaginal deliveries
- Impact of maternal age on delivery outcomes following spontaneous labour at term
- Maternal characteristics of pregnancies with intrauterine fetal demise
- Evaluation of standardized, computerized Dawes/Redman heart-rate analysis based on different recording methods and in relation to fetal beat-to-beat heart rate variability
- Perinatal outcomes with isolated oligohydramnios at term pregnancy
- Factors associated with choice of delivery with or without epidural analgesia among laboring women: a cross-sectional survey at a tertiary care hospital of a developing country
- Ultrasonographic assessment of cervical length in pregnancies scheduled for a cesarean delivery: prediction of early spontaneous onset of labor
- Characterization of visceral and subcutaneous adipose tissue transcriptome in pregnant women with and without spontaneous labor at term: implication of alternative splicing in the metabolic adaptations of adipose tissue to parturition
- Classification of stillbirths is an ongoing dilemma
- Out-of-hospital births in the United States 2009–2014
- Congress Calendar
- Congress Calendar