Human Placental Histopathology in Preterm Stillbirth: One Center's Experience

Abstract

Our aim is to identify maternal risk factors and to determine placental histopathologies in preterm stillbirths. We designed a prospective study involving a patient population (n = 136) composed of singleton stillbirth (n = 40) and singleton live-born neonates (n = 96) between 23 0/7 and 36 6/7 weeks of gestation. We divided the stillbirths into groups of early (n = 21) and late (n = 19) stillbirths. Statistical analyses were performed using SPSS version 15 software. Small birth weight for gestational age and oligo-anhydramnios were significantly higher in the early stillbirth group (p = 0.001, p = 0.002 respectively). Antenatal follow up was significantly lower in the late stillbirth group (p = 0.001). Placental weight was statistically lower in the early stillbirth group (p = 0.001). We found no significant differences in maternal vascular underperfusion, fetal vascular obstruction, inflammation and villitis of unknown etiology. Placental pathologies causing preterm labor may play an important role in the etiology of stillbirths and antenatal follow up is essential for each pregnancy.

In a Genomic Era, Placental Pathology Still Holds the Key in the Nondysmorphic Stillbirth

“…Placental pathology has been shown to occur more frequently in the stillborn population and may give insight into causation and thus prevention. 4,5 It is unclear what impact new genetic testing methodologies will have on stillbirth diagnosis and counselling, and it is important to remember that in the majority of stillbirths, an explanation is more likely to come from detailed autopsy and placental pathology. For developing countries, genetic testing can be expensive; therefore, routine placental analysis may offer a more cost-effective means of assessing stillbirth.…”

“…Numerical and structural chromosomal anomalies are a major cause of stillbirth and perinatal morbidity and mortality. [3][4][5] Our center has been consistently using microarray studies alongside QF-PCR for aneuploidy detection on postmortem fetal tissue since mid-2010.…”