Classification of stillbirths is an ongoing dilemma
| Autor: | Federica Trezza, Pantaleo Greco, Gloria Bonaccorsi, Gennaro Scutiero, Irene Riezzo, Chiara Borghi, Emanuela Turillazzi, Vittorio Fineschi, Luigi Nappi, Pantaleo Bufo |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Cause of death classification systems pregnancy complications stillbirth unexplained fetal death Autopsy Gestational Age Diagnostic evaluation World health NO Cohort Studies 03 medical and health sciences cause of death 0302 clinical medicine Pregnancy Medicine Humans 030212 general & internal medicine Fetal Death Retrospective Studies 030219 obstetrics & reproductive medicine business.industry Obstetrics and Gynecology Gestational age Placental histology Classification Italy Pediatrics Perinatology and Child Health Cohort Unexplained death Female business |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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