Abstract：
OBJECTIVE: The study aimed to evaluate the causes of death and associated factors in cases of stillbirth, using post-mortem examination and applying a rigorous, evidence-based holistic approach.
METHODS: Our retrospective observational study included cases of autopsy following stillbirth that occurred at our tertiary medical center during a period of 8 years. Detailed up-to-date criteria that incorporate clinical reports, medical history, prenatal imaging, and histopathological findings were used to evaluate the cause of death and associated factors.
RESULTS: After applying our proposed methodology, 138 cases of stillbirth were classified into eight categories based on the causes of death. A definitive cause of death was observed in 100 (72%) cases, while 38 (28%) cases were considered unexplained. The leading cause of death was placental lesions (n = 39, 28%) with maternal vascular malperfusion (MVM) lesions being the most common (54%). Ascending infection was the second most common cause of fetal death (n = 24, 17%) and was often seen in the setting of preterm labor and cervical insufficiency.
CONCLUSIONS: The largest category of cause of death was attributed to placental pathology. Using rigorous detailed up-to-date criteria that incorporate pathological and clinical factors may help in objectively classifying the cause of death.
METHODS: Our retrospective observational study included cases of autopsy following stillbirth that occurred at our tertiary medical center during a period of 8 years. Detailed up-to-date criteria that incorporate clinical reports, medical history, prenatal imaging, and histopathological findings were used to evaluate the cause of death and associated factors.
RESULTS: After applying our proposed methodology, 138 cases of stillbirth were classified into eight categories based on the causes of death. A definitive cause of death was observed in 100 (72%) cases, while 38 (28%) cases were considered unexplained. The leading cause of death was placental lesions (n = 39, 28%) with maternal vascular malperfusion (MVM) lesions being the most common (54%). Ascending infection was the second most common cause of fetal death (n = 24, 17%) and was often seen in the setting of preterm labor and cervical insufficiency.
CONCLUSIONS: The largest category of cause of death was attributed to placental pathology. Using rigorous detailed up-to-date criteria that incorporate pathological and clinical factors may help in objectively classifying the cause of death.
摘要：
目的：本研究旨在评估死产病例的死亡原因和相关因素，使用验尸和应用严格的，基于证据的整体方法。
方法：我们的回顾性观察研究包括在我们的三级医疗中心进行的8年期间死产后的尸检病例。包含临床报告的详细最新标准，病史,产前成像,和组织病理学结果用于评估死亡原因和相关因素。
结果：应用我们提出的方法后，根据死亡原因将138例死产分为八类。在100例（72％）病例中观察到明确的死亡原因，38例（28％）被认为原因不明。死亡的主要原因是胎盘病变（n=39，28％），其中母亲血管灌注不良（MVM）病变最常见（54％）。上升感染是胎儿死亡的第二大常见原因（n=24，17％），在早产和宫颈功能不全的情况下经常出现。
结论：最大的死亡原因是胎盘病理。使用包含病理和临床因素的严格详细的最新标准可能有助于对死亡原因进行客观分类。
方法：我们的回顾性观察研究包括在我们的三级医疗中心进行的8年期间死产后的尸检病例。包含临床报告的详细最新标准，病史,产前成像,和组织病理学结果用于评估死亡原因和相关因素。
结果：应用我们提出的方法后，根据死亡原因将138例死产分为八类。在100例（72％）病例中观察到明确的死亡原因，38例（28％）被认为原因不明。死亡的主要原因是胎盘病变（n=39，28％），其中母亲血管灌注不良（MVM）病变最常见（54％）。上升感染是胎儿死亡的第二大常见原因（n=24，17％），在早产和宫颈功能不全的情况下经常出现。
结论：最大的死亡原因是胎盘病理。使用包含病理和临床因素的严格详细的最新标准可能有助于对死亡原因进行客观分类。
