Sergi Consolato M, Spencer Deborah, Al-Jishi Taher
Department of Anatomic Pathology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
Department of Pathology, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina, United States.
J Lab Physicians. 2023 Apr 18;15(4):475-487. doi: 10.1055/s-0043-1764485. eCollection 2023 Dec.
Stillbirth is a dramatic event for the parents, health care team, and anyone close to the expectant parents. Multidisciplinary team (MDT) meetings are essential to improve communication in health care. We review the most frequent findings discussed at MDT meetings. A PubMed search was conducted through December 2021 since the inception (1965) using clinical queries with the key terms "stillbirth" AND "investigation" AND "pathology" AND "human." The search strategy included reviews, meta-analyses, randomized controlled trials, clinical trials, and observational studies. This systematic review is based on, but not limited to, the search results. It is the experience of more than 30 years of pediatrics, obstetrics, and pathology staff. Two hundred and six articles were screened and complemented through the perusal of congressional activities and personal communications. Pathological findings following perinatal death can be divided into macroscopic, histologic, and placental findings. The placenta is crucial in fetal medicine and is key in determining the cause of stillbirth in a substantial number of events. Perinatal lung disease is essential to evaluate the response of newborns to extrauterine life and address newborns' outcomes appropriately. Stillbirth remains one of the less explored areas of medicine, and we can determine the cause in a limited number of cases. Nevertheless, placental pathology is critical in the etiology discovery pathway. Accurate investigations and discussion of photography-supported findings are vital in promoting communication at MDT meetings.
死产对于父母、医护团队以及任何与准父母关系密切的人来说都是一个重大事件。多学科团队(MDT)会议对于改善医疗保健中的沟通至关重要。我们回顾了MDT会议上讨论的最常见的发现。
自1965年开始至2021年12月,我们在PubMed上进行了搜索,使用临床查询,关键词为“死产”、“调查”、“病理学”和“人类”。搜索策略包括综述、荟萃分析、随机对照试验、临床试验和观察性研究。本系统综述基于但不限于搜索结果。它是30多年来儿科、产科和病理科工作人员的经验总结。
通过查阅国会活动和个人交流筛选并补充了206篇文章。围产期死亡后的病理发现可分为宏观、组织学和胎盘发现。胎盘在胎儿医学中至关重要,并且在许多情况下是确定死产原因的关键。围产期肺部疾病对于评估新生儿对宫外生活的反应以及适当地处理新生儿的结局至关重要。
死产仍然是医学中较少被探索的领域之一,我们只能在有限数量的病例中确定病因。然而,胎盘病理学在病因发现途径中至关重要。准确的调查以及对有照片支持的发现进行讨论对于促进MDT会议上的沟通至关重要。