title: Practice of pathological examinations in stillbirths: A 10-year retrospective study.
abstract: OBJECTIVE
  To describe the practice of fetal and placental pathological examinations in a large series of spontaneous stillbirths over 10 years.
  
  
  METHODS
  Inclusion of cases recorded by the Lower Normandy Regional Fetal-Infant Mortality Observatory (observatoire régional de mortalité fœto-infantile) from January 1, 2005 to December 31, 2014. The possible cause of death was coded in accordance with the ReCoDe classification system.
  
  
  RESULTS
  Seven hundred and forty-four cases were recorded. The placental examinations were conducted in 93.7% of cases (CI95%[91.7-95.3]), increasing over the study period, and an autopsy was proposed in 87.2% of cases (CI95%[84.8-89.6]). Autopsy was conducted less frequently during the most recent period, with parental refusal increasing over time. In multivariate analysis, no factor was associated with a higher frequency of placental examinations, while autopsy was proposed more often under certain circumstances: less than 4 pregnancies (P<10-2), birth weight from 1000 to 1500 grams (P=0.05), singleton (P<10-2), clinical context not suggesting a cause (P<10-3), type 1 or 2 maternity ward (P<10-2), antepartum death (P<10-3).
  
  
  CONCLUSIONS
  Placental analysis was almost systematically realized, as suggested by international guidelines. Fetal autopsy was often performed, however only in some specific circumstances. New practice guidance to realize customized fetal autopsies appear to be necessary.
authors.affiliation: Perinatal Network, CHU de Caen, 14000 Caen, France; Gynecology-Obstetrics Unit, CHU de Caen, 14000 Caen, France. Electronic address: jones_frederique@hotmail.fr.
authors.forename: F
authors.initials: F
authors.lastname: Jones
authors.affiliation: Perinatal Network, CHU de Caen, 14000 Caen, France.
authors.forename: P
authors.initials: P
authors.lastname: Thibon
authors.affiliation: Perinatal Network, CHU de Caen, 14000 Caen, France; Gynecology-Obstetrics Unit, CHU de Caen, 14000 Caen, France; Pathological Anatomy Unit, CHU de Caen, 14000 Caen, France.
authors.forename: M
authors.initials: M
authors.lastname: Guyot
authors.affiliation: Cytogenetics Unit, CHU de Caen, 14000 Caen, France; Neonatal Unit, CHU de Caen, 14000 Caen, France; Pathological Anatomy Unit, CHU de Caen, 14000 Caen, France.
authors.forename: A
authors.initials: A
authors.lastname: Molin
authors.affiliation: Perinatal Network, CHU de Caen, 14000 Caen, France; Pathological Anatomy Unit, CHU de Caen, 14000 Caen, France.
authors.forename: C
authors.initials: C
authors.lastname: Jeanne-Pasquier
authors.affiliation: Perinatal Network, CHU de Caen, 14000 Caen, France; Medical School, University of Caen Lower-Normandy, 14000 Caen, France; Neonatal Unit, CHU de Caen, 14000 Caen, France.
authors.forename: B
authors.initials: B
authors.lastname: Guillois
authors.affiliation: Perinatal Network, CHU de Caen, 14000 Caen, France; Gynecology-Obstetrics Unit, CHU de Caen, 14000 Caen, France; Neonatal Unit, CHU de Caen, 14000 Caen, France.
authors.forename: G
authors.initials: G
authors.lastname: Benoist
authors.affiliation: Perinatal Network, CHU de Caen, 14000 Caen, France; Gynecology-Obstetrics Unit, CHU de Caen, 14000 Caen, France; Neonatal Unit, CHU de Caen, 14000 Caen, France.
authors.forename: M
authors.initials: M
authors.lastname: Dreyfus
mesh_terms: D000328:Adult; D001344:Autopsy / Q000706:statistics & numerical data*; D005260:Female; D005333:Fetus / Q000473:pathology*; D005602:France / Q000453:epidemiology; D020073:Gravidity; D006801:Humans; D019102:Infant, Very Low Birth Weight; D015999:Multivariate Analysis; D010920:Placenta / Q000473:pathology*; D011247:Pregnancy; D012189:Retrospective Studies; D050497:Stillbirth / Q000453:epidemiology*
keywords: Autopsie fœtale; Examen anatomo-pathologique du placenta; Fetal autopsy; MFIU; Pathological examination of the placenta; Practice; Pratiques; Stillbirth