Mekni Karima, Khiari Hyem, Tissaoui Ameni, Belaid Khaoula, Habassi Imène, Elfekih Chiraz
Department of Obstetrics and Gynecology, Mahmoud El Matri Hospital, Ariana, 2080, Manouba, Tunisia.
Faculty of Medicine, El Manar University, Tunis, Tunisia.
Arch Gynecol Obstet. 2025 Jul;312(1):107-117. doi: 10.1007/s00404-025-07955-2. Epub 2025 Mar 19.
Stillbirth is a public health problem and one of the main obstetrical complications of pregnancy that practitioners can ever witness. A careful etiological investigation and a search for risk factors is necessary. The main objective of our study was to identify the causes of stillbirths using the CODAC classification system.
It was a monocentric retrospective descriptive study conducted over 5 years in our gynecology department. We collected 114 cases.
The overall frequency was 8.26 ‰. The average age of women was 32.19 years. Women came from an urban environment in 48.2% and had a low level of education in 54.4% of cases. Our patients were moderately obese (48%). A history of stillbirth was found in 33 cases (28.9%), and the average term of pregnancy was 32 weeks' gestation. Pregnancy was poorly monitored in 2/3 of the population studied. The most frequent reason for consultation was a decrease/absence of fetal movement perception (30%). Labor was induced in 53.5% of deliveries. Delivery was by vaginal route in 58% of cases and the male sex was predominant (61%). For funicular anomalies, a placental abruption was found in 21.1% of cases, and a cord loop in 11.4%. For the etiological investigation via the CODAC classification, maternal pathologies were the most frequent with 28.07% of cases dominated by hypertension. Placental pathologies (placental abruption) and cord abnormalities (cord loop) represented, respectively, 22 and 21.05%. An unexplained cause was found in 20.17%.
For the etiological investigation, we relied on the CODAC classification to minimize unexplained causes. This etiological investigation is essential not only to provide answers for the bereaved couple but also to prevent the recurrence of such incidents in subsequent pregnancies.
死产是一个公共卫生问题，也是从业者可能目睹的主要妊娠产科并发症之一。进行仔细的病因调查并寻找风险因素是必要的。我们研究的主要目的是使用CODAC分类系统确定死产原因。
这是一项在我们妇科进行的为期5年的单中心回顾性描述性研究。我们收集了114例病例。
总体发生率为8.26‰。女性的平均年龄为32.19岁。48.2%的女性来自城市环境，54.4%的病例教育程度较低。我们的患者中度肥胖（48%）。33例（28.9%）有死产史，平均孕周为32周。在所研究人群的三分之二当中，孕期监测不佳。最常见的就诊原因是胎动感知减少/消失（30%）。53.5%的分娩进行了引产。58%的病例通过阴道分娩，男性占多数（61%）。关于脐带异常，21.1%的病例发现胎盘早剥，11.4%发现脐带绕颈。通过CODAC分类进行病因调查时，母体疾病最为常见，占28.07%，其中高血压为主。胎盘疾病（胎盘早剥）和脐带异常（脐带绕颈）分别占22%和21.0
