Fetoplacental malformations and abnormalities. A retrospective analysis of 398 cases.

##plugins.themes.academic_pro.article.main##

Sana Ben Slama
Leila Mebazaa
Dhouha Bacha
Saadia Bouraoui
Sabeh Mzabi-Regaya
Ahlem Lahmar

Abstract

Background: The fetoplacental examination is actually very important and sometimes necessary to confirm or correct prenatal diagnosis. Aim : to deduce a list of indications of fetoplacental examination and to determine the type and frequency of malformations found.
Methods: a retrospective study including 398 consecutive fetoplacental examinations, including abortions, stillbirths and children died perinatally. The cases were referred in the department of pathology of the M. Slim Hospital (North Tunis) from 1992 and 2012.
Results: The mean maternal age was 32,58 years. The average gravidity was 2,65 and the average rate was 1,48. Maternal conditions were dominated by preeclampsia. The main indication motivating the request for fetoplacental examination was a spontaneous abortion in 45,73% of cases. The rate of stillbirths was 15,61% and that of children who died in the perinatal period was 13,28%. The sex ratio was 1,4 and the medium term was 19,38 SA. 170 fetuses had abnormalities (43,14%). The most frequent abnormalities were chromosomal aberrations (27,64%), followed by facial abnormalities (25,88%) and central nervous system abnormalities (18,82%). We examined 283 placentas, 49% of them contained abnormalities. Ischemic lesions were the main placental abnormalities (41%).
Conclusions:  An efficient fetopathological examination should be as complete as possible, including examination of placenta. Everything must be integrated into a data collection and complete clinical information.

Keywords:

Epidemiology - fetopathology - Fetus - Abnormalities - Placenta

##plugins.themes.academic_pro.article.details##

References

  1. Horn LC, Langner A, Stiehl P, Wittekind C, Faber R. Identification of the causes of intrauterine death during 310 consecutive autopsies. Eur J Obstet Gynecol Reprod Biol 2004;113:134-8.
  2. Roux C, Migne G, Mulliez N, Youssef S. Fréquence de malformations à la naissance. Étude d'une maternité parisienne pendant cinq ans. J Gynecol Obstet Biol Reprod 1982;11:215-26.
  3. Clayton-Smith J, Farndon PA, McKeown C, Donnai D. Examination of fetuses after induced abortion for fetal abnormality. BMJ 1990;300:295-7.
  4. Becher JC, Bell JE, Keeling JW, Liston WA, McIntosh N, Wyatt B. The Scottish Perinatal Neuropathology Study--clinicopathological correlation in stillbirths. BJOG 2006;113:310-7.
  5. Carles D, Serville F, Albertie EM, Weichhold W. Analyse de 1410 examens foetopathologiques pratiqués au CHU de Bordeaux. J Gynecol Obstet Biol Reprod 1991;20:577-86.
  6. Marton T, Hargitai B, Patkós P, Csapó Z, Szende B, Papp Z. Practice of fetal pathological examination. OrvHetil 1999;140:1411-6.
  7. Robert E, Roch SR , Boggio D, Haag P. Incidence des malformations des voies excrétrices urinaires (VEU) dans la région Rhône-Alpes. A propos de 1357 cas d'enfants atteints, identifiés pendant une période de 7 ans (1976-1982). J Genet Hum 1984;32:107-11.
  8. Bonetti LR, Ferrari P, Trani N et al. The role of fetal autopsy and placental examination in the causes of fetal death: a retrospective study of 132 cases of stillbirths. Arch Gynecol Obstet 2011;283:231-41.
  9. Thornton CM, O'Hara MD. A regional audit of perinatal and infant autopsies in Northern Ireland. Br J Obstet Gynaecol 1998;105:18-23.
  10. Woods DL, Draper RR. A clinical assessment of stillborn infants. S Afr Med J 1980;57:441-3.
  11. Agapitos E, Papadopoulou C, Kavantzas N, Papoulias J, Antonaki V, Davaris P. Thecontribution of pathological examination of the placenta in the investigation of the causes of foetal mortality. Arch Anat Cytol Pathol 1996;44:5-11.
  12. Faye-Petersen OM, Guinn DA, Wenstrom KD. Value of perinatal autopsy. Obstet Gynecol 1999;94:915-20.
  13. Tang MY, Zhu YN, Xu H, Gai MY, Ji XC, Zhao SM. Clinicopathological analysis of causes of perinatal deathChin Med J 1989;102:672-8.
  14. Khong TY. The placenta in stillbirth. Current Diagnostic Pathology. Issue 3,2006, Pages 161-72.
  15. Pà sztor N, Keresztúri A, Kozinszky Z, Pál A. Identification of causes of stillbirth through autopsy and placental examination reports. Fetal Pediatr Pathol 2014;33:49-54.
  16. Kidron D, Bernheim J, Aviram R. Placental findings contributing to fetal death, a study of 120 stillbirths between 23 and 40 weeks gestation. Placenta 2009;30:700-4.
  17. Tellefsen CH, Vogt C. How important is placental examination in cases of perinatal deaths? Pediatr Dev Pathol 2011;14:99-104.
  18. Emmrich P, Horn LC, Seifert U. Morphologic findings in fetuses and placentas of late abortion in the 2nd trimester. Zentralbl Gynakol 1998;120:399-405.
  19. Wainwright HC. My approach to performing a perinatal or neonatal autopsy. J Clin Pathol 2006;59:673-80.