The First 5-Year-Long Survey on Intrauterine Unexplained Sudden Deaths from the Northeast Italy.
OBJECTIVE
Sudden intrauterine unexplained death syndrome (SIUDS) represents one of the main open issues in the scientific and social setting of the modern medicine, and our efforts have aimed to understand its possible causes and risk factors.


METHODS
A 43-case series of consecutive unexplained fetal deaths coming from Northeast Italy, collected in a 5-year period (2011-2015), has been submitted to an in-depth investigation, based on neuropathological and cardiopathological examinations, immunohistochemistry for neuronal nuclear antigen (NeuN), genetic characterization for the serotonin transporter (5-HTT) gene polymorphisms, and toxicological environmental analyses.


RESULTS
The overall survey from the neuropathological findings highlights one or more congenital morphological abnormalities of the autonomic nervous system in 77% of cases of sudden fetal deaths.


CONCLUSIONS
From our results emerges the need to perform a complete autopsy of all SIUDS victims with an in-depth examination of the neuronal centers of the brainstem, which modulate the vital functions.
a Provincial Health Care Services , Institute of Pathology, Santa Maria del Carmine Hospital , Rovereto ( TN ), Italy.|b Department of Diagnostic and Clinical Medicine and of Public Health , Section of Pathology, University of Modena and Reggio Emilia , Modena ( MO ), Italy.
Luca
L
Roncati
a Provincial Health Care Services , Institute of Pathology, Santa Maria del Carmine Hospital , Rovereto ( TN ), Italy.
Teresa
T
Pusiol
a Provincial Health Care Services , Institute of Pathology, Santa Maria del Carmine Hospital , Rovereto ( TN ), Italy.
Francesco
F
Piscioli
b Department of Diagnostic and Clinical Medicine and of Public Health , Section of Pathology, University of Modena and Reggio Emilia , Modena ( MO ), Italy.
Giuseppe
G
Barbolini
b Department of Diagnostic and Clinical Medicine and of Public Health , Section of Pathology, University of Modena and Reggio Emilia , Modena ( MO ), Italy.
Antonio
A
Maiorana
c Department of Biomedical , Surgical and Dental Sciences, Lino Rossi Research Center, University of Milan , Milan ( MI ), Italy.
Anna
A
Lavezzi
D001921:Brain / Q000002:abnormalities; D003645:Death, Sudden / Q000209:etiology / Q000473:pathology; D005260:Female; D005313:Fetal Death / Q000209:etiology*; D006330:Heart Defects, Congenital / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D007231:Infant, Newborn; D007558:Italy; D008137:Longitudinal Studies; D008297:Male; D066087:Perinatal Death / Q000209:etiology*
autopsy; cardiopathology; neuronal nuclear antigen (NeuN); neuropathology; pesticides; serotonin transporter (5-HTT); sudden intrauterine unexplained death syndrome (SIUDS)