Unexplained antenatal fetal death in full-term pregnancy

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Abstract

Objective. To identify the features of anamnestic data, the course of pregnancy and the results of pathological examination in patients with antenatal death of full-term fetuses depending on the presence of meconium in the amniotic fluid.

Materials and methods. A retrospective analysis of individual pregnancy records, birth histories, and autopsy reports for 83 cases of stillbirth from 2021 to 2023 was conducted. The patients were divided into 2 groups: Group I included the patients with meconium-stained amniotic fluid (MSAF) (n=55); Group II included the patients with clear amniotic fluid (n=28).

Results. The patients in Group I most often had a history of induced abortion (p=0,048), abnormal placental attachment, and oligohydramnios, that can be a marker of MSAF (p=0,041). At the time of fetal death, the length of pregnancy in Group I was longer than in Group II (p=0,003). The frequency of fatty involution of thymus was comparable in stillbirths in both groups. The signs of chronic placental insufficiency and inflammatory-immune disorders were observed in most placental samples collected from both groups.

Conclusion. No direct association was found between fetal distress that led to antenatal death and MSAF. The probability of MSAF increases with increasing gestational age and oligohydramnios. More intensive fetal monitoring is essential in the second half of the third trimester of pregnancy in high-risk patients.

About the authors

Mark A. Kurtser

Pirogov Russian National Research Medical University, Ministry of Health of Russia (Pirogov University)

Email: kurtser_ma@rsmu.ru
ORCID iD: 0000-0003-0175-1968

Academician of the RAS, Dr. Med. Sci., Professor, Head of the Academician G.M. Savelyeva Department of Obstetrics and Gynecology, Institute of Motherhood and Childhood

Russian Federation, Moscow

Sergey A. Kalashnikov

Pirogov Russian National Research Medical University, Ministry of Health of Russia (Pirogov University)

Email: kalashnikov_sa@rsmu.ru
ORCID iD: 0000-0003-2658-5417

Dr. Med. Sci., Professor, Academician G.M. Savelyeva Department of Obstetrics and Gynecology, Institute of Motherhood and Childhood

Russian Federation, Moscow

Ksenia Y. Voskoboeva

Pirogov Russian National Research Medical University, Ministry of Health of Russia (Pirogov University)

Author for correspondence.
Email: voskoboeva96@bk.ru
ORCID iD: 0000-0003-4484-2229

PhD student, Academician G.M. Savelyeva Department of Obstetrics and Gynecology, Institute of Motherhood and Childhood

Russian Federation, Moscow

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