Placental findings: a series of cases of Intra Uterine Fetal Deaths in Argentine Septentrional Patagonia using consensus terminology
Damián Leonardo Taire (1), María Soledad Silva (2), María Gabriela Manzzi (3) Rafael Santapau (3)
(1) Pediatric Pulmonology Office, Department of Pediatrics, Zonal Hospital “Dr. Andrés R. Isola”, Puerto Madryn, Argentina; (2) Department of Neonatology, Zonal Hospital “Dr. Andrés R. Isola”, Puerto Madryn, Argentina ;(3) Department of Pathology, Oncology Center, Puerto Madryn, Argentina.
We present a series of 28 cases of Intra Uterine Fetal Deaths (IUFD) with histopathology of the fetus and placenta. The series collects perinatal mortality data from 4 private health institutions in the cities of Puerto Madryn and Trelew. The objective of this presentation is to determine the frequency of placental pathology of the presented series of IUFD during the years 2006-2018. Placental pathology contributes to or causes stillbirth in 11 to 65% of cases in various classifications. We assessed perinatal deaths where placental disease is the main cause of death, focusing on maternal vascular malperfusion (MVM) and fetal vascular malperfusion (FVM).
Retrospective, cross-sectional, observational and descriptive design. The documentation consulted are the reports of fetal autopsies.
During the period 2006-2018, all cases of stillbirths (≥24 weeks of gestation or birthweight ≥500 g) were included when placental disease was the main cause of death or an associated factor (n = 28). The mean gestational age was 32.2 weeks. With respect to the sex of IUFD: female sex 42.8% and male sex 57.1%. The average weight was 1751 grams. The placenta average weight was 240 grams. The ratio of placenta weight (PW) to birth weight (BW) (PW_BW_Ratio) was calculated from PW and BW. PW_BW_Ratio were 0.16 (all), female (0.19) and male (0.15). MVM and FVM were reported in 35.7% and 57.14% of stillbirths, respectively. There were 3 (10.71%) cases with both MVM and FVM. MVM was more common in males (70%). FVM was similar in females and males (50%). Co-existing pathologies included intra-uterine growth restriction (10% of MVM) and cord pathology (81.2% of FVM).
This paper presents local epidemiological data on the theme chosen in the delimited period. There are not, at the moment, publications in our environment that evaluate the impact of placental pathology in cases of MFIU. The frequency of placental pathology is consistent with previous studies.
The ethical approval for the study was granted by the Bioethics Committee of the Zonal Hospital of Trelew (Reference: 11/03/2019).