Home > Journals > Minerva Ginecologica > Past Issues > Minerva Ginecologica 2005 August;57(4) > Minerva Ginecologica 2005 August;57(4):397-410

CURRENT ISSUE
 

JOURNAL TOOLS

eTOC
To subscribe PROMO
Submit an article
Recommend to your librarian
 

ARTICLE TOOLS

Reprints
Permissions

 

REVIEWS  PREGNANCY 

Minerva Ginecologica 2005 August;57(4):397-410

Copyright © 2005 EDIZIONI MINERVA MEDICA

language: English

The analysis of factors predicting antepartum stillbirth

Pasupathy D., Smith G. C. S.


PDF


Antepartum stillbirth is the single most common cause of perinatal death. Antepartum stillbirth is associated with fetal abnormality, congenital infection, rhesus isoimmunisation, maternal medical conditions, and complications of pregnancy, such as pre-eclampsia and placental abruption. However, the majority have no direct obstetric cause and are referred to as unexplained. Many of these so-called unexplained deaths are associated with growth restriction. Maternal characteristics, such as age and smoking, are associated with an increased risk of antepartum stillbirth. The risk of stillbirth in late pregnancy is related to the function of the placenta in early pregnancy. Placental function can be assessed using circulating markers in the mothers blood, such as pregnancy associated plasma protein A and alpha-fetoprotein. Invasion of the trophoblast into the uterine vessels is associated with decreased resistance to flow in the uterus and impaired placentation is reflected in high resistance Doppler flow velocity waveforms in the utero-placental circulation. Both circulating placental markers and Doppler indices of resistance to flow are predictive of the risk of antepartum stillbirth. However, none of these tools has sufficient positive predictive value to justify population based screening. Future research in unexplained stillbirth should be directed towards developing better predictive tests to identify women at high risk and the evaluation of interventions in large scale trials.

top of page