Primary causes of perinatal death

Agapitos, Emmanouil; Kouri, Efi; Alexacos, L.; Bacoula, C.; Papacharalampous, N

doi:10.1016/s0344-0338(86)80049-8

Cited by 2 publications

(1 citation statement)

References 3 publications

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“…This high occurrence is consistent with other studies since preterm neonates are susceptible to infections. (20)(21)(22) . Most of our cases were early-onset pneumonia, and their occurrence was inversely proportional to GA, which is similar to reports elsewhere.…”

Section: Discussionmentioning

confidence: 99%

Major postmortem pulmonary histopathological findings in preterm infants in Ethiopia

Tola,

Perez,

Nigussie

et al. 2023

Preprint

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Background Respiratory disorders are the leading cause of death in preterm infants. Postmortem lung histological findings may help to confirm or exclude a clinical diagnosis. This study aims to describe the common postmortem pulmonary histological findings and their potential contributions to preterm neonatal mortality in Ethiopia. Methods A prospective, multicenter, and cross-sectional clinical study of preterm infants was conducted in five hospitals in three regions of Ethiopia. A total of 4,919 preterm infants were enrolled, and of these, 3,852 were admitted to neonatal intensive care units (NICUs). Within 28 days of postnatal age, 1,109 or 29% of those admitted to the NICU died. Consent was requested from all parents for a complete diagnostic autopsy (CDA) and was obtained in 441 of the preterm neonates who died. Histopathological examination of representative lung tissues was performed. Results On histopathologic examination of the lungs of these deceased preterm neonates, the major abnormal histological changes observed were hyaline membrane disease (HMD) in 81.6%, pneumonia in 44.7%, pulmonary hemorrhage or diffuse alveolar hemorrhage (DAH) in 39%, and meconium aspiration syndrome (MAS) in 5.9%. A combination of histopathological findings, two or more, were also observed in > 30% of the preterm lungs. Conclusions HMD was the most common pulmonary finding in extremely and moderately preterm infants. The highly prevalent pneumonia and pulmonary hemorrhage, together with the frequently observed HMD, might have significantly contributed to their deaths. Histopathological findings, beyond confirming a clinical suspicion, can be used as an input in redesigning clinical-radiological parameters to identify respiratory pathologies, particularly pneumonia, in preterm infants.

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Section: Discussionmentioning

confidence: 99%

Major postmortem pulmonary histopathological findings in preterm infants in Ethiopia

Tola,

Perez,

Nigussie

et al. 2023

Preprint

View full text Add to dashboard Cite

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Value of the Perinatal Autopsy: Critique

Erwich²,

2002

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In consenting to a perinatal autopsy, the primary motive of parents may be to find the exact cause of death. A critical review on the value of perinatal autopsies was performed to see whether parents could be counseled regarding their main motive. A literature search was performed in MEDLINE, EXCERPTA MEDICA, and the Cochrane library. We evaluated the value of the autopsy by comparing the clinical and autopsy diagnoses in stillbirths, neonatal deaths, and therapeutic terminations. Clinicopathologic concordance was divided into four categories: (1) change in diagnosis, (2) additional findings, (3) complete confirmation, and (4) inconclusive. We sought information on factors that may influence the value of perinatal autopsies: the type and definitions of perinatal loss; autopsy rate; level of hospital; expertise of pathologists; autopsy protocol used; whether patients were inborn or referred; and antenatal diagnosis. From the 27 articles that met our review criteria, the autopsy revealed a change in diagnosis or additional findings in 22% to 76% of cases. If confirmation of clinical findings is included, then the value of the perinatal autopsy was as high as up to 100%. Factors that could influence this rate were reported variably by investigators. When centers report their experience of the value of the perinatal autopsy, information on the factors that may influence their reports should be provided as well. Clinicians can confidently advise parents of the usefulness of the perinatal autopsy in ascertaining the cause of death or for counseling their future pregnancies.

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Primary causes of perinatal death

Cited by 2 publications

References 3 publications

Major postmortem pulmonary histopathological findings in preterm infants in Ethiopia

Major postmortem pulmonary histopathological findings in preterm infants in Ethiopia

Value of the Perinatal Autopsy: Critique

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