[Macroscopic and histopathological changes in the fetal appendages as a factor in the pathogenesis of intrauterine fetal death ].

BACKGROUND: Intrauterine fetal death is an agonizing, often unpredictable event. Autopsies of stillborn fetuses, including placentas, umbilical cord and fetal membranes, are performed to clarify the cause of death. Autopsy results are not always easily understood by the patients and difficult to clarify by the specialists. OBJECTIVE: To evaluate the macroscopic pathological and histopathological changes in placenta, umbilical cord and fetal membranes as a factor in the pathogenesis of intrauterine fetal death. MATERIALS AND METHODS: Retrospective review of 129 autopsy reports of singleton stillborn fetuses and placentas from 23 to 41 weeks of gestation. RESULTS: Macroscopic and histopathological findings in the placenta, often in combination with inflammatory changes prevailing in premature cases, while macroscopic and histopathological findings in umbilical cord predominate in term stillborn. In 11% of cases there were no specific pathological findings. CONCLUSIONS: Pathological analysis of the placenta is essential for clarifying the pathogenesis of stillbirths. Simplifying the classification of pathological results of fetal appendages at autopsy categories--changes in the placenta, changes in the umbilical cord and inflammatory changes may contribute to easier interpretation and allows for comparison of results.

[Fetal growth curve based on gestational age and fetal maturity].

Most of the fetal growth charts available in the literature were created too long ago, based on various populations and using various eligibility criteria. The purpose of our study was to develop a nomogram of fetal weights based on the gestational age and neonatal maturity. The study is prospective and retrospective in nature. 1,748 fetuses of 20 to 40 gestational weeks were assessed directly after birth, and all cases were classified based on the number of weeks of pregnancy completed, but fetuses were not classified based on their gender. The mean weekly weight gain of fetuses was 100 g until the 30 gestation week, and 200 g thereafter. The results we obtained for the 50th percentile for fetus weight were weights meanly 200 g lower than those per Babson's chart (Fenton's scale). The weights in the 10th percentile were also 50-100 g lower until the 31 gestation week, with increasing difference to 150 g thereafter. For 2011, the incidence of growth-retarded fetuses at Maichin Dom Hospital was 7.09% per Babson's chart, and 5.1% according to our data of the 10th percentile. The study demonstrated that nomograms for relevant populations should be used to assess normal growth of fetuses.