The contribution of pathological examination of the placenta in the investigation of the causes of foetal mortality.

The purpose of this study was to evaluate the significance of histological examination of the placenta during routine post-mortem examination of foetal, perinatal and early neonatal deaths with particular reference to the cause of death. Three hundred (300) placentas were examinated over a period of three years (1988-1991). The clinical history, autopsy examination and placental histological examination were taken into account to determine the cause of death. Autopsy findings revealed the cause of death in only 33 cases (12.9%). In contrast, placental examination allowed us to determine the cause of death in 123 cases (48.4%) especially in abortions (54.4%). The most frequent abnormalities found were vascular insufficiency in intrauterine deaths (16.47%) and acute chorioamnionitis with foetal involvement in abortions (31.4%). Fifty six (56) cases with diagnoses of acute chorioamnionitis, chronic villitis of unknown aetiology and erythroblastosis were classified in the highrisk group for a subsequent pregnancy. Routine histological examination of the placenta following a perinatal death constitutes a necessary complement to autopsy examination, as it provides essential information for the cause of death and therefore helps in planning and more effective prenatal monitoring of a future pregnancy.