Gunn T R, Becroft D M
Aust N Z J Obstet Gynaecol. 1984 Feb;24(1):17-22. doi: 10.1111/j.1479-828x.1984.tb03315.x.
Twenty stillborn infants with unexplained intracranial haemorrhages were identified in a review of approximately 3,500 perinatal postmortems performed between 1966 and 1982. After apparently uneventful pregnancies, fetal death occurred before the onset of labour and was recognized at a mean of 10 days before delivery; 80% had subdural haemorrhages, others had intraventricular and/or intracerebral haemorrhages, and many had haemorrhages at more than one of these sites. These haemorrhages were of sufficient size to have caused death and no other causes were found at postmortem examinations. All 20 mothers were immigrants to New Zealand from the Pacific Islands and almost all were older, married, multi-gravidas with uneventful medical histories and in stable socio-economic circumstances. In the period studied the incidence of stillbirths with unexplained intracranial haemorrhages was 1.15 per 1,000 Pacific Islander births and, at one hospital, these haemorrhages were found in 14.6% of Pacific Islander stillbirths. There were no unexplained intracranial haemorrhages in other racial groups. Prenatal subdural haemorrhage without a history of maternal trauma is extremely rare. In the absence of supporting maternal histories and other fetal or maternal injuries the possibility that these are 'battered' fetuses remains circumstantial.
在对1966年至1982年间进行的约3500例围产期尸检的回顾中，发现了20例原因不明的颅内出血死产儿。在孕期看似正常后，胎儿在临产前死亡，平均在分娩前10天被确认；80%有硬膜下出血，其他有脑室内和/或脑内出血，许多在这些部位不止一处有出血。这些出血的规模足以导致死亡，尸检未发现其他死因。所有20位母亲都是从太平洋岛屿移民到新西兰的，几乎所有人年龄较大、已婚、多产，既往病史正常，社会经济状况稳定。在所研究的时期，原因不明的颅内出血死产的发生率为每1000例太平洋岛民出生中有1.15例，在一家医院，这些出血在14.6%的太平洋岛民死产中被发现。其他种族群体中没有原因不明的颅内出血情况。无母亲创伤史的产前硬膜下出血极为罕见。在缺乏支持性的母亲病史以及其他胎儿或母亲损伤的情况下，这些胎儿是“受虐”胎儿的可能性仍只是一种推测。
