OBJECTIVE: We sought to evaluate the contribution of different diagnostic tests for determining cause of fetal death. Our goal was to propose a workup guideline. STUDY DESIGN: In a multicenter prospective cohort study from 2002 through 2008, for 1025 couples with fetal death ≥20 weeks' gestation, an extensive nonselective diagnostic workup was performed. A panel classified cause and determined contribution of diagnostics for allocating cause. RESULTS: A Kleihauer-Betke, autopsy, placental examination, and cytogenetic analysis were abnormal in 11.9% (95% confidence interval [CI], 9.8-14.2), 51.5% (95% CI, 47.4-55.2), 89.2% (95% CI, 87.2-91.1), and 11.9% (95% CI, 8.7-15.7), respectively. The most valuable tests for determination of cause were placental examination (95.7%; 95% CI, 94.2-96.8), autopsy (72.6%; 95% CI, 69.2-75.9), and cytogenetic analysis (29.0%; 95% CI, 24.4-34.0). CONCLUSION: Autopsy, placental examination, cytogenetic analysis, and testing for fetal maternal hemorrhage are basic tests for workup after fetal death. Based on the results of these tests or on specific clinical characteristics, further sequential testing is indicated.
OBJECTIVE: We sought to evaluate the contribution of different diagnostic tests for determining cause of fetal death. Our goal was to propose a workup guideline. STUDY DESIGN: In a multicenter prospective cohort study from 2002 through 2008, for 1025 couples with fetal death ≥20 weeks' gestation, an extensive nonselective diagnostic workup was performed. A panel classified cause and determined contribution of diagnostics for allocating cause. RESULTS: A Kleihauer-Betke, autopsy, placental examination, and cytogenetic analysis were abnormal in 11.9% (95% confidence interval [CI], 9.8-14.2), 51.5% (95% CI, 47.4-55.2), 89.2% (95% CI, 87.2-91.1), and 11.9% (95% CI, 8.7-15.7), respectively. The most valuable tests for determination of cause were placental examination (95.7%; 95% CI, 94.2-96.8), autopsy (72.6%; 95% CI, 69.2-75.9), and cytogenetic analysis (29.0%; 95% CI, 24.4-34.0). CONCLUSION: Autopsy, placental examination, cytogenetic analysis, and testing for fetal maternal hemorrhage are basic tests for workup after fetal death. Based on the results of these tests or on specific clinical characteristics, further sequential testing is indicated.
Authors: Alexa A Freedman; Robert M Silver; Karen J Gibbins; Carol J Hogue; Robert L Goldenberg; Donald J Dudley; Halit Pinar; Carolyn Drews-Botsch Journal: Paediatr Perinat Epidemiol Date: 2019-07 Impact factor: 3.980
Authors: E M McClure; A Garces; S Saleem; J L Moore; C L Bose; F Esamai; S S Goudar; E Chomba; M Mwenechanya; O Pasha; A Tshefu; A Patel; S M Dhaded; C Tenge; I Marete; M Bauserman; S Sunder; B S Kodkany; W A Carlo; R J Derman; P L Hibberd; E A Liechty; K M Hambidge; N F Krebs; M Koso-Thomas; M Miodovnik; D D Wallace; R L Goldenberg Journal: BJOG Date: 2017-01-31 Impact factor: 6.531
Authors: S L Son; A A Allshouse; J M Page; M P Debbink; H Pinar; U Reddy; K J Gibbins; B J Stoll; C B Parker; D J Dudley; M W Varner; R M Silver Journal: BJOG Date: 2020-10-14 Impact factor: 6.531
Authors: Aleena M Wojcieszek; Emily Shepherd; Philippa Middleton; Glenn Gardener; David A Ellwood; Elizabeth M McClure; Katherine J Gold; Teck Yee Khong; Robert M Silver; Jan Jaap Hm Erwich; Vicki Flenady Journal: Cochrane Database Syst Rev Date: 2018-04-30
Authors: Elizabeth M McClure; Carl L Bose; Ana Garces; Fabian Esamai; Shivaprasad S Goudar; Archana Patel; Elwyn Chomba; Omrana Pasha; Antoinette Tshefu; Bhalchandra S Kodkany; Sarah Saleem; Waldemar A Carlo; Richard J Derman; Patricia L Hibberd; Edward A Liechty; K Michael Hambidge; Nancy F Krebs; Melissa Bauserman; Marion Koso-Thomas; Janet Moore; Dennis D Wallace; Alan H Jobe; Robert L Goldenberg Journal: Matern Health Neonatol Perinatol Date: 2015-05-04
Authors: Imogen Ptacek; Anna Smith; Ainslie Garrod; Sian Bullough; Nicola Bradley; Gauri Batra; Colin P Sibley; Rebecca L Jones; Paul Brownbill; Alexander E P Heazell Journal: BMC Clin Pathol Date: 2016-02-09