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围产期尸检的诊断价值:486例病例分析。

Diagnostic value of perinatal autopsies: analysis of 486 cases.

作者信息

Neşe Nalan, Bülbül Yeşim

机构信息

Department of Pathology, Faculty of Medicine, Celal Bayar University, Manisa 45030, Turkey, Tel.: +90-236-4444228/1614, Fax: +90-236-2338040.

Department of Obstetrics and Gynecology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey.

出版信息

J Perinat Med. 2018 Feb 23;46(2):175-181. doi: 10.1515/jpm-2016-0396.

DOI:10.1515/jpm-2016-0396
PMID:28841576
Abstract

AIM

Autopsy is a beneficial procedure to determine the cause of death and the frequency of anomalies in perinatal losses. Even in the event of an autopsy not providing any additional information, completion of the procedure confirming the clinical diagnoses gives reassurance to both clinicians and parents. Here we present a 15-year archival study based on findings of perinatal autopsies.

DESIGN AND METHODS

Four hundred and eighty-six cases from our archive were reviewed and according to the findings they were divided into three subcategories; (1) miscarriages (MCF); (2) fetuses terminated (FTA) for vital anomalies detected by prenatal ultrasonography; (3) premature or term newborns died within first month of life (neonates: NN). Autopsies were documented and classified according to week/age of cases, anomalies and causes of abortion or death.

RESULTS

Two hundred and twenty-six of 486 cases (46.5%) were in MCF group while 227 (46.7%) and 33 (6.8%) were of them in FTA and NN groups, respectively. In FTA group, the most frequent anomaly detected was neural tube defects. In NN group, prematurity related complications were the most common cause of death. The autopsy process was found valuable in 39.7% of all cases.

CONCLUSIONS

We suggest that autopsy procedure is diagnostically valuable even in situations when there is USG findings that are confirming FTAs or there is no important major fetal or placental anomaly detected in MCFs.

摘要

目的

尸检是确定围产期死亡原因和异常情况发生率的有益方法。即使尸检未提供任何额外信息,完成该程序以确认临床诊断也能让临床医生和家长都安心。在此,我们基于围产期尸检结果进行了一项为期15年的档案研究。

设计与方法

回顾了我们档案中的486例病例,并根据结果将其分为三个子类别;(1)自然流产(MCF);(2)因产前超声检查发现的重大异常而终止妊娠的胎儿(FTA);(3)在出生后第一个月内死亡的早产儿或足月儿(新生儿:NN)。根据病例的孕周/年龄、异常情况以及流产或死亡原因对尸检进行记录和分类。

结果

486例病例中,226例(46.5%)属于MCF组,而FTA组和NN组分别有227例(46.7%)和33例(6.8%)。在FTA组中,最常检测到的异常是神经管缺陷。在NN组中,早产相关并发症是最常见的死亡原因。在所有病例中,39.7%的尸检过程被认为有价值。

结论

我们认为,即使在超声检查结果证实FTA或MCF中未检测到重要的主要胎儿或胎盘异常的情况下,尸检程序在诊断上也是有价值的。

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