Macroscopic and histopathological changes in the fetal appendages as a factor in the pathogenesis of intrauterine fetal death

Background: Intrauterine fetal death is an agonizing, often unpredictable event. Autopsies of stillborn fetuses, including placentas, umbilical cord and fetal membranes, are performed to clarify the cause of death. Autopsy results are not always easily understood by the patients and difficult to clarify by the specialists.

Objective: To evaluate the macroscopic pathological and histopathological changes in placenta, umbilical cord and fetal membranes as a factor in the pathogenesis of intrauterine fetal death.

Methods: Retrospective review of 129 autopsy reports of singleton stillborn fetuses and placentas from 23 to 41 weeks of gestation.

Results: Macroscopic and histopathological findings in the placenta, often in combination with inflammatory changes prevailing in premature cases, while macroscopic and histopathological findings in umbilical cord predominate in term stillborn. In 11% of cases there were no specific pathological findings.

Conclusions: Pathological analysis of the placenta is essential for clarifying the pathogenesis of stillbirths. Simplifying the classification of pathological results of fetal appendages at autopsy categories--changes in the placenta, changes in the umbilical cord and inflammatory changes may contribute to easier interpretation and allows for comparison of results.