Miscarriage Death Research Articles

Placental Findings Contributing to Fetal Death, a Study of 120 Stillbirths between 23 and 40 Weeks Gestation

Background Intrauterine fetal death is an agonizing, often unpredictable event. Autopsies of stillborn fetuses, including placentas, are performed to clarify the cause of death. Autopsy results are not always easily understood by the patients or their healthcare providers. Objective To evaluate placental causes of death in stillbirths based on autopsy and placental findings that are related to maternal underperfusion, fetal underperfusion, or inflammatory etiologies in hierarchical order. Methods Retrospective review of 120 autopsy reports of singleton stillborn fetuses and placentas from 23 to 40 weeks of gestation. Results Among the placental causes of death there were 54(51%) cases with direct cause or major contributor to death in the etiology of maternal vascular supply abnormalities, 28(26%) cases in the etiology of fetal vascular supply abnormalities and 13(12%) in the etiology of inflammatory lesions. Maternal vascular supply abnormalities were more common in preterm stillbirths and fetal vascular supply abnormalities were more common among term stillbirths. In 88% of stillbirths, the direct cause or a major contributor to death was found in the placentas. The incidence of unexplained death was 8%. Conclusions Pathological analysis of the placenta is essential for clarifying causes of stillbirths. Using specific simplified categories for abnormal placental findings may increase the benefits of the autopsy report.

Alterations of Biological Features of the Cerebellum in Sudden Perinatal and Infant Death

This article intends to show how the cerebellum, a structure ordinarily not considered in mediating breathing or cardiovascular control, may play a critical role in compensatory responses particularly to hypoxic insults occurring pre and/or postnatally and thus may be involved in the sudden unexplained perinatal and infant death. Besides the ontogenesis of the cerebellar cortex in man, we reported alterations of biopathological features (neuronal immaturity, altered apoptotic programs, negative expression of somatostatin and EN2 gene, intense c-fos expression positivity, astrogliosis) in the cortex and in the dentate nucleus of the 63% of sudden deaths, and only in 10% of the controls. The correlation of these results with the mother's smoking habit was highly significant. Therefore, we support the hypothesis, already expressed in previous studies on brainstem, of a close relation between maternal cigarette smoking and a wide range of morpho-physiological defects of the brain, leading to unexplained sudden death in stillbirths, newborns, and Sudden Infant Death Syndrome (SIDS) victims.

Hmong Women and Reproduction. By Pranee Liamputtong Rice. Westport, Conn.: Greenwood Publishing Group, Inc., 2000. 344 pp. $65.00.

Introduction The History and the Culture The Hmong Hmong Women in Hmong Society Hmong Healers and Hmong Medicines Women and Childbearing Conception and Pregnancy Birth Nyob Nruab Hlis--Thirty Days Confinement Birth in a New Homeland Women and Childrearing Childrearing and Infant Care Beliefs about Breastmilk and Infant Feeding Practices Childhood Health and Illness Women and Reproductive Health Unsuccessful Reproduction: Infertility and Miscarriage Death in Birth: Stillbirth, Neonatal, and Maternal Death Fertility Regulation: Menstruation Regulation, Contraception, and Abortion Blood Magic: Menstruation and Menopause By Way of Conclusion--Motherhood in a New Country

A computer-based method for cause of death classification in stillbirths and neonatal deaths.

In large-scale epidemiological studies of stillbirths and neonatal deaths a method is needed to replace detailed medical record audits in order to determine the cause of death. A computer-based method is presented for determination of the cause of death in stillbirths and in neonatal deaths. It utilizes information in the Swedish medical registries. The study comprises 6044 dead infants born in Sweden from 1983-1990. For each infant the program determines 31 basic characteristics which are important in deciding the cause of death. Based on these characteristics a modified Wigglesworth's classification is used to find the cause of death. The validity of the method was checked by comparing the computer generated information with information obtained by scrutinizing medical records for a 10% representative sample (603 infants). Specificity and sensitivity for each basic characteristic varied, but for the modified Wigglesworth cause of death classification the concordance was 88%. The weakest data refer to intrauterine deaths, where pertinent information was often missing in the medical registries. The method can be used for large-scale epidemiological studies.

NETHERLANDS

<h3>Mortality from Stillbirths</h3> An interesting statistical inquiry has been made by Dr. Wesselink as to the causes of death in stillbirths. The inquiry covers all births from 1907 to 1916, or more than 1,500,000 births, with 3.95 per cent, or nearly 16,000, stillbirths. An important observation was to the effect that the number of stillbirths is always the lowest for the third quarter of each year. The mortality from stillbirths is lower in the cities than in the rural districts. In searching for the causes of stillbirths, it was noted that syphilis is ten times more frequent in the cities than in the country. On the other hand, dystocia due to anatomic malformations is a more common cause of death in the rural districts. In view of these two facts (lower urban mortality from stillbirths in spite of the greater frequency of syphilis, and the higher frequency in the rural