January 17th, 2021

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Intrauterine Growth Retardation in Case of a Stillbirth: How Does It Really Matter?
Authors:  Norbert Pásztor, M.D., Zoltan Kozinszky, M.D., Ph.D., and Attila Keresztúri, M.D., Ph.D.
  OBJECTIVE: To compare the autopsy and placental histopathological examination results of intrauterine growth retardation (IUGR) and non-IUGR fetal deaths.

STUDY DESIGN: Postmortem examination and obstetric risk of stillbirths from 1996 to 2012 were reviewed retrospectively at the Department of Obstetrics and Gynecology, University of Szeged. Forty-seven percent of the 153 stillbirths out of the 34,673 births were registered as IUGR.

RESULTS: Umbilical cord anomaly as an underlying cause of death was significantly less prevalent among IUGR stillbirths and predominantly occurred in late pregnancy. Oligohydramnios (p<0.001) and maternal hypertensive diseases (<0.05) were associated with greater risk of IUGR among stillbirths. Placental insufficiency was more associated to preeclampsia (p<0.05) and maternal hypertensive diseases (p<0.001) among the IUGR group than in the non-IUGR group. Any degree of placental degeneration was not a distinguishable factor for growth retardation.

CONCLUSION: A more intensive surveillance of IUGR and high-risk pregnancies could lead to an improvement in the stillbirth rate; however, the prevention strategies of IUGR stillbirths remain questionable because of very early prematurity.
Keywords:  autopsy; fetal mortality; infant, premature; intrauterine growth retardation; obstetric risk; placenta; placental histology; pregnancy; pregnancy complications; stillbirth
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