Abstract：
UNASSIGNED: Canadian stillbirth data are limited, and a significant proportion of pregnancies resulting in stillbirth have no attributable cause. The objective of this study was to characterize stillbirth case investigations and management at a tertiary care hospital in Ontario, Canada.
UNASSIGNED: This was a retrospective chart review study of all cases of singleton stillbirth at The Ottawa Hospital between 1 January 2012 and 31 December 2017. Terminations and multiples stillbirths were excluded. Chart reviews were conducted to extract maternal sociodemographic, obstetrical, and fetal characteristics, including results from antenatal ultrasounds, autopsy, placenta pathology, and laboratory investigations.
UNASSIGNED: A total of 155 eligible cases of stillbirth were identified, resulting in a 6-year stillbirth rate of 4.2 per 1000 total births. The median maternal age was 31.0 years (IQR: 29.0, 35.0) and the median gestational age at delivery was 28 weeks (IQR: 24, 35). A total of 9 (5.8%) pregnant individuals had a history of previous stillbirth. Of the 155 stillbirths, 35% underwent the full suite of post-loss laboratory, placental, and fetal autopsy investigations. 63.2% of cases had post-loss laboratory investigations completed. 76% and 71% of cases had fetal autopsy and placenta pathology evaluations completed, respectively. Antenatal characteristics associated with stillbirth included fetal anomalies/genetic markers (27.1%), umbilical cord and placental anomalies (24.5%), fetal growth abnormalities (27.7%), cervical/uterine abnormalities (11.6%), and amniotic fluid abnormalities (25.1%). The most common autopsy findings included evidence of infection (22.7%), fetal anomalies (12.6%), and fetal hypoxia (10%). The most common placental pathology findings included features of placental insufficiency (21.8%), retroplacental abnormalities (16.3%), and umbilical cord accident/infarct (15.4%).
UNASSIGNED: Our findings demonstrate that as many as two-thirds of singleton stillbirth cases at our center did not receive the post-perinatal loss investigations recommended by clinical practice guidelines. More thorough collection of post-stillbirth data at all levels (institutional, provincial, national) is warranted to improve our understanding of stillbirth epidemiology, etiology, and management in Canada.
UNASSIGNED: This was a retrospective chart review study of all cases of singleton stillbirth at The Ottawa Hospital between 1 January 2012 and 31 December 2017. Terminations and multiples stillbirths were excluded. Chart reviews were conducted to extract maternal sociodemographic, obstetrical, and fetal characteristics, including results from antenatal ultrasounds, autopsy, placenta pathology, and laboratory investigations.
UNASSIGNED: A total of 155 eligible cases of stillbirth were identified, resulting in a 6-year stillbirth rate of 4.2 per 1000 total births. The median maternal age was 31.0 years (IQR: 29.0, 35.0) and the median gestational age at delivery was 28 weeks (IQR: 24, 35). A total of 9 (5.8%) pregnant individuals had a history of previous stillbirth. Of the 155 stillbirths, 35% underwent the full suite of post-loss laboratory, placental, and fetal autopsy investigations. 63.2% of cases had post-loss laboratory investigations completed. 76% and 71% of cases had fetal autopsy and placenta pathology evaluations completed, respectively. Antenatal characteristics associated with stillbirth included fetal anomalies/genetic markers (27.1%), umbilical cord and placental anomalies (24.5%), fetal growth abnormalities (27.7%), cervical/uterine abnormalities (11.6%), and amniotic fluid abnormalities (25.1%). The most common autopsy findings included evidence of infection (22.7%), fetal anomalies (12.6%), and fetal hypoxia (10%). The most common placental pathology findings included features of placental insufficiency (21.8%), retroplacental abnormalities (16.3%), and umbilical cord accident/infarct (15.4%).
UNASSIGNED: Our findings demonstrate that as many as two-thirds of singleton stillbirth cases at our center did not receive the post-perinatal loss investigations recommended by clinical practice guidelines. More thorough collection of post-stillbirth data at all levels (institutional, provincial, national) is warranted to improve our understanding of stillbirth epidemiology, etiology, and management in Canada.
摘要：
■加拿大的死产数据有限，导致死产的怀孕中有很大一部分没有可归因。这项研究的目的是描述安大略省三级医院的死产病例调查和管理，加拿大。
这是一项回顾性图表回顾研究，研究了2012年1月1日至2017年12月31日在渥太华医院发生的所有单胎死胎病例。终止和多次死产被排除。进行图表审查以提取产妇的社会人口统计学，产科,和胎儿特征，包括产前超声检查的结果，尸检,胎盘病理学,和实验室调查。
■共确定了155例合格的死产病例，导致6年死胎率为每1000名总新生儿4.2例。产妇年龄中位数为31.0岁（IQR：29.0，35.0），分娩时的胎龄中位数为28周（IQR：24，35）。共有9名（5.8％）孕妇有死胎史。在155例死产中，35%的人接受了全套的损失后实验室，胎盘,和胎儿尸检调查.63.2%的病例完成了损失后实验室调查。76%和71%的病例完成了胎儿尸检和胎盘病理评估，分别。与死产相关的产前特征包括胎儿异常/遗传标记（27.1％），脐带和胎盘异常（24.5%），胎儿生长异常（27.7%），宫颈/子宫异常（11.6%），和羊水异常(25.1%)。最常见的尸检结果包括感染证据(22.7%),胎儿异常(12.6%),和胎儿缺氧(10%)。最常见的胎盘病理表现包括胎盘功能不全（21.8%），胎盘后异常（16.3%），脐带意外/梗塞（15.4%）。
我们的研究结果表明，我们中心有多达三分之二的单胎死胎病例没有接受临床实践指南推荐的围产期后死亡调查。更彻底地收集各级死产后数据(机构，省,国家)有必要提高我们对死产流行病学的理解，病因学,和管理在加拿大。
这是一项回顾性图表回顾研究，研究了2012年1月1日至2017年12月31日在渥太华医院发生的所有单胎死胎病例。终止和多次死产被排除。进行图表审查以提取产妇的社会人口统计学，产科,和胎儿特征，包括产前超声检查的结果，尸检,胎盘病理学,和实验室调查。
■共确定了155例合格的死产病例，导致6年死胎率为每1000名总新生儿4.2例。产妇年龄中位数为31.0岁（IQR：29.0，35.0），分娩时的胎龄中位数为28周（IQR：24，35）。共有9名（5.8％）孕妇有死胎史。在155例死产中，35%的人接受了全套的损失后实验室，胎盘,和胎儿尸检调查.63.2%的病例完成了损失后实验室调查。76%和71%的病例完成了胎儿尸检和胎盘病理评估，分别。与死产相关的产前特征包括胎儿异常/遗传标记（27.1％），脐带和胎盘异常（24.5%），胎儿生长异常（27.7%），宫颈/子宫异常（11.6%），和羊水异常(25.1%)。最常见的尸检结果包括感染证据(22.7%),胎儿异常(12.6%),和胎儿缺氧(10%)。最常见的胎盘病理表现包括胎盘功能不全（21.8%），胎盘后异常（16.3%），脐带意外/梗塞（15.4%）。
我们的研究结果表明，我们中心有多达三分之二的单胎死胎病例没有接受临床实践指南推荐的围产期后死亡调查。更彻底地收集各级死产后数据(机构，省,国家)有必要提高我们对死产流行病学的理解，病因学,和管理在加拿大。
