Perinatal Pathology:Perinatal Pathology:A ReviewA Review

Dr G MortimerDr G Mortimer

UCHGalwayUCHGalway

Totals 2003Totals 2003

Mothers: 1,203P 1,941M = Mothers: 1,203P 1,941M = 3,1443,144

Babies: 1,223P 1,976M = Babies: 1,223P 1,976M = 3,1993,199

Singletons: 1,183P 1,907M = Singletons: 1,183P 1,907M = 3,0903,090

Twins: 20P 33M = 53Twins: 20P 33M = 53Triplets: 0P 1M = 1Triplets: 0P 1M = 1

Total BabiesTotal Babies

1999: 2,7041999: 2,7042000: 2,8302000: 2,8302001: 3,0012001: 3,0012002: 3,2182002: 3,2182003: 3,1992003: 3,199

Multiple BirthsMultiple Births

1999: Twins 48, Triplets 6; Total = 541999: Twins 48, Triplets 6; Total = 542000: Twins 45, Triplets 0; Total = 452000: Twins 45, Triplets 0; Total = 452001: Twins 42, Triplets 1; Total = 432001: Twins 42, Triplets 1; Total = 432002: Twins 56, Triplets 4; Total = 602002: Twins 56, Triplets 4; Total = 602003: Twins 53, Triplets 1; Total = 542003: Twins 53, Triplets 1; Total = 542004: Twins 61, Triplets 0; Total = 612004: Twins 61, Triplets 0; Total = 61

Non-National DeliveriesNon-National Deliveries

1999: 18 0.6%1999: 18 0.6%2000: 59 2.0%2000: 59 2.0%2001: 202 6.8%2001: 202 6.8%2002: 361 11.5%2002: 361 11.5%2003: 364 11.5%2003: 364 11.5%

Perinatal Mortality RatesPerinatal Mortality Rates

1999 2000 2001 2002 1999 2000 2001 2002 20032003

Stillbirths 0.5% 0.8% 0.7% 0.5% Stillbirths 0.5% 0.8% 0.7% 0.5% 0.7%0.7%

NND 0.4% 0.3% 0.2% 0.4% NND 0.4% 0.3% 0.2% 0.4% 0.3%0.3%

Total Rate 0.9% 1.1% 0.9% 0.9% Total Rate 0.9% 1.1% 0.9% 0.9% 1.0%1.0%

Perinatal Loss 2003Perinatal Loss 2003

Total = 31Total = 3121 Antepartum Stillbirths21 Antepartum Stillbirths10 Neonatal Deaths10 Neonatal Deaths

Perinatal DeathsPerinatal Deaths

Autopsy No AutopsyAutopsy No AutopsyAll: 31 17 (55%) 14 (45%)All: 31 17 (55%) 14 (45%)NND: 10 3 (30%) 7 (70%)NND: 10 3 (30%) 7 (70%)SB: 21 14 (66%) 7 (33%)SB: 21 14 (66%) 7 (33%)

Perinatal Deaths 2003Perinatal Deaths 2003

Stillbirths: 9P 12M = 21 (0.7%)Stillbirths: 9P 12M = 21 (0.7%)Early NND: 6P 4M = 10 (0.3%)Early NND: 6P 4M = 10 (0.3%)Total: 15P 16M = 31 (1.0%)Total: 15P 16M = 31 (1.0%)

Causes Antepartum DeathsCauses Antepartum Deaths

Prims Multips TotalPrims Multips Total

Unexplained 3 9 12Unexplained 3 9 12

Abruptio 2 1 3Abruptio 2 1 3

TTS 2 0 2TTS 2 0 2

Cord Accident 1 1 2Cord Accident 1 1 2

IUGR 0 1 1IUGR 0 1 1

Malformation 1 0 1Malformation 1 0 1

Stillbirths UCHG 1973-1992Stillbirths UCHG 1973-1992

1973-82 1983-921973-82 1983-92 Congenital anomalies Congenital anomalies 62 3162 31 Asphyxia Asphyxia 75 20 75 20 PET PET 41 541 5 Maternal disease Maternal disease 25 725 7 IUGR IUGR 55 27 55 27 Unexplained Unexplained 33 6033 60 Other Other 30 430 4 Total 321 154Total 321 154

Stillbirth Rate/1000 UCHG 1973-Stillbirth Rate/1000 UCHG 1973-19921992

1973-82 1983-921973-82 1983-92 Congenital anomalies Congenital anomalies 2.3 1.22.3 1.2 Asphyxia Asphyxia 2.7 0.82.7 0.8 PET PET 1.4 0.21.4 0.2 Maternal disease Maternal disease 0.9 0.30.9 0.3 IUGR IUGR 2.0 1.02.0 1.0 Unexplained Unexplained 1.2 2.371.2 2.37 Other Other 1.1 0.151.1 0.15 Total 11.7 5.98Total 11.7 5.98

Causes Neonatal DeathsCauses Neonatal Deaths

Prims Multips TotalPrims Multips TotalMalformations 2 1 3Malformations 2 1 3Prematurity 3 0 3Prematurity 3 0 3 Infection 0 1 1Infection 0 1 1TTS 0 2 2TTS 0 2 2Abruptio 1 0 1Abruptio 1 0 1

Autopsies 2004Autopsies 2004

Total : 14Total : 14Neonates : 5Neonates : 5Stillbirths : 9Stillbirths : 9

Neonatal Autopsies 2004Neonatal Autopsies 2004

Twins TTS MoDi EarlyTwins TTS MoDi EarlyT2 Premature DiDi/Infarct EarlyT2 Premature DiDi/Infarct EarlyRDS LateRDS LateCongenital Anomaly Early Congenital Anomaly Early

Stillbirth Autopsies 2004Stillbirth Autopsies 2004

Unexplained 7Unexplained 7Congenital Anomaly 2Congenital Anomaly 2

Unexplained Stillbirths 2004 Unexplained Stillbirths 2004 (8)(8)

Twins TTS MoDi InfarctionTwins TTS MoDi InfarctionT1 DiDi Infarction T1 DiDi Infarction

Acute chorioamnionitis + InfarctionAcute chorioamnionitis + InfarctionAcute chorioamnionitis + SROMAcute chorioamnionitis + SROM Infarct + PET-type maternal Infarct + PET-type maternal

vasculopathyvasculopathy

Sudden Infant Death Syndrome Sudden Infant Death Syndrome 20042004

2 Cases2 Cases