Page Jessica M, Silver Robert M
Department of Obstetrics & Gynecology, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Curr Opin Obstet Gynecol. 2018 Apr;30(2):130-135. doi: 10.1097/GCO.0000000000000441.
To review current evidence regarding the most useful tests for evaluation of potential causes of stillbirth.
Stillbirth remains one of the most devastating obstetric complications. Recent advances include work investigating the highest yield diagnostic tests for determining a cause of death in stillbirths. Placental pathology and fetal autopsy improve the diagnostic yield when combined with maternal clinical history. Additional tools include genetic evaluation, and testing for antiphospholipid antibodies and fetal-maternal hemorrhage based on the clinical scenario. However, routine testing for heritable thrombophilias or infection has not proven to be useful. In cases in which fetal autopsy is not acceptable to patients or possible for logistical reasons, alternative forms of fetal evaluation should be considered.
A systematic approach to stillbirth evaluation is useful in identifying a potential cause of death. This should incorporate clinical information as well as placental pathology and fetal autopsy. Based on clinical characteristics further testing may be indicated.
回顾目前关于评估死产潜在病因最有用检测方法的证据。
死产仍然是最具毁灭性的产科并发症之一。近期进展包括研究用于确定死产死因的高产出诊断检测方法。胎盘病理学检查和胎儿尸检结合产妇临床病史可提高诊断率。其他工具包括基因评估，以及根据临床情况检测抗磷脂抗体和胎儿-母体出血。然而，遗传性血栓形成倾向或感染的常规检测尚未证明有用。在患者不接受胎儿尸检或因后勤原因无法进行胎儿尸检的情况下，应考虑其他形式的胎儿评估。
采用系统方法评估死产有助于确定潜在死因。这应包括临床信息以及胎盘病理学检查和胎儿尸检。根据临床特征，可能需要进一步检测。
