Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK.
Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK; UCL Great Ormond Street Institute of Child Health, London, UK; NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK.
Clin Radiol. 2020 Jul;75(7):561.e25-561.e34. doi: 10.1016/j.crad.2020.03.007. Epub 2020 Apr 3.
To determine whether the presence of internal calcifications on perinatal post-mortem skeletal surveys (PMSS) are associated with certain diagnoses of fetal loss.
A 6-month retrospective, single-centre, cohort study was conducted on PMSS performed for perinatal death assessment. One reader re-reviewed all PMSS images for the presence and location of internal calcifications, and noted whether these were included within the original radiology report. Findings at autopsy were then reviewed independently by a second researcher and cause of fetal loss or main diagnosis recorded. Chi-squared tests were conducted to identify differences between those with and without internal calcifications at PMSS.
Two hundred and thirty perinatal deaths (mean gestational age 18 weeks; average 12-35 weeks) were included in the study, of which 42 (18.3%) demonstrated intra-abdominal calcifications, and 16/42 (38.1%) were mentioned in the radiology reports. Most calcifications were found to be within the lumen of the gastrointestinal tract, and in the left upper quadrant of the abdomen. There was no statistical difference between identifiable causes for fetal loss at autopsy in cases with and without calcification at PMSS (59.5% versus 58.5% respectively, p=0.904). Nevertheless, where calcification and a cause for fetal loss were found, the aetiology was more likely to be due a fetal rather than placental issue.
The presence of internal calcifications on PMSS was not associated with an increased likelihood of explainable fetal loss or particular diagnosis at autopsy.
确定围产期死后骨骼检查（PMSS）中是否存在内部钙化与某些胎儿丢失诊断之间是否存在关联。
对围产期死亡评估进行的为期 6 个月的回顾性、单中心队列研究。一位读者重新审查了所有 PMSS 图像，以确定内部钙化的存在和位置，并注意这些钙化是否包含在原始放射学报告中。然后，由第二位研究人员独立审查尸检结果，并记录胎儿丢失的原因或主要诊断。进行卡方检验以确定 PMSS 有无内部钙化的两组之间是否存在差异。
本研究共纳入 230 例围产期死亡（平均胎龄 18 周；平均 12-35 周），其中 42 例（18.3%）存在腹腔内钙化，16/42 例（38.1%）在放射学报告中提及。大多数钙化位于胃肠道内腔内，位于上腹部左象限。在 PMSS 有钙化和无钙化的病例中，尸检时可识别的胎儿丢失原因之间没有统计学差异（分别为 59.5%和 58.5%，p=0.904）。尽管如此，在发现钙化和胎儿丢失原因的情况下，病因更可能是胎儿而不是胎盘问题。
PMSS 上存在内部钙化与可解释的胎儿丢失或尸检时特定诊断的可能性增加无关。
