rome and Fetal-Death

One of the aims of necropsy at neonatal and infantile ages is to identify the causes of death in this population, which is decreasing continuously because of the decay in natality seen in Italy as well as in other western countries over the last few decades. Analysis of 2410 autopsies performed on 92% of deaths in infants under one year of age occurring at the Bambino Gesù Hospital in Rome in 1974-89 shows a striking change in the principal causes of death in recent decades: Malformations, neonatal anoxia and immaturity have now become the main causes of death in the first year of life, while there is a very low rate of nutritional and infectious diseases, which predominated in the past. The autopsy results obtained indicate, however, that the policy of paediatric care in public health systems must be changed.

Topics: Autopsy; Cause of Death; Congenital Abnormalities; Fetal Death; Heart Defects, Congenital; Humans; Hypoxia; Infant; Infant Mortality; Infant, Newborn; Rome

In order to analyse causes of stillbirths, we collected all the cases observed from January 1993 to December 2006 at the Department of Gynecological Sciences, Perinatology and Child Care, University ''La Sapienza'', Rome, Italy.. For each case, age of the patient, parity, country of origin, gestational age at the moment of stillbirth, clinical condition before pregnancy, pathologies occurred during pregnancy, possible therapies and autopsy of the fetus, have been collected. To evaluate and classify the obtained data, both the NICE (Neonatal and Intrauterine Death Classification according to Etiology) and the ReCoDe (Relevant Condition at Death) classifications have been utilised; the first one being more suitable than the second for our case series.. Results showed that among 25892 labours, 186 were intrauterine deaths (7.2%). In 1999 we noticed a decrease in the number of labours of approx. 30%, due to a reduction in the number of inpatients available spaces. The number of stillbirths presented a slithering line until 2001, while after then a marked decrease has been observed.. A high percentage of stillbirths had to be classified as ''unknown causes'' (26.9%). Additional prospective research, in order to achieve a better classification, is needed. All the new cases, should be classified using the most appropriate parameter, drawing attention to all the possible issues, and centralizing the data acquired.

Topics: Cause of Death; Death Certificates; Female; Fetal Death; Gestational Age; Hospitals, Pediatric; Humans; Pregnancy; Risk Factors; Rome; Stillbirth

Topics: Abortion, Induced; Abortion, Spontaneous; Adolescent; Birth Weight; Cesarean Section; Congenital Abnormalities; Delivery, Obstetric; Extraction, Obstetrical; Female; Fetal Death; Humans; Infant, Newborn; Obstetrical Forceps; Pregnancy; Pregnancy Complications; Pregnancy in Adolescence; Rome

Topics: Cesarean Section; Delivery, Obstetric; Female; Fetal Death; Humans; Italy; Obstetric Labor Complications; Pregnancy; Rome; Statistics as Topic; Universities