morphine and Stillbirth

Stillbirth is one of the most devastating adverse pregnancy outcome, but it is often associated with a missing post-mortem histological examination. We aimed at evaluating whether the staining of amniotic fluid reflects the fetal conditions surrounding the death and if it correlates with any histologic sign of fetal distress.. Terminal gasping (represented by the massive presence of intra-alveolar squamous cells), thymic and adrenal cortex modifications were evaluated as histologic signs of fetal distress in stillbirths, and stratified according to the degree of staining of the amniotic fluid.. The presence of meconium-stained amniotic fluid did not correlate with the presence of gasping and/or thymic and/or adrenal cortex changes. Clear amniotic fluid was not associated with the absence of histologic signs of distress.. The evaluation of the staining of the amniotic fluid fails to identify distressed fetuses. A histologic evaluation of fetal organs provides detailed information, irrespective of the presence/absence of meconium-stained amniotic fluid.

Topics: Amniotic Fluid; Female; Fetal Distress; Humans; Infant, Newborn; Meconium; Meconium Aspiration Syndrome; Pregnancy; Stillbirth

Topics: Abdominal Wall; Duodenum; Female; Fetal Diseases; Hernia, Abdominal; Humans; Infant, Newborn; Interdisciplinary Communication; Intestine, Small; Meconium; Obstetric Labor, Premature; Patient Care Team; Peritonitis; Pregnancy; Stillbirth; Ultrasonography, Doppler; Ultrasonography, Prenatal; Young Adult

The authors present a case of stillbirth in which histologic examination of the placenta provides the opportunity to make a definitive diagnosis of a death due to fetal thrombotic vasculopathy (FTV). Establishing the etiology in cases of stillbirth may avoid medical malpractice litigation. The better knowledge of the cause of stillbirths also helped obstetricians to recognize factors that could have prejudiced future pregnancies.

Topics: Adult; Erythroblastosis, Fetal; Female; Forensic Pathology; Humans; Liability, Legal; Malpractice; Meconium; Placenta; Placenta Diseases; Pregnancy; Stillbirth; Vascular Diseases