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Placental Histologic Criteria for Diagnosis of Cord Accident: Sensitivity and Specificity.
MedLine Citation:
PMID:  22400796     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract Objective: "Cord accident" (compromised umbilical blood flow) as a cause of stillbirth is under-reported, mainly due to lack of diagnostic criteria. We have previously established histologic criteria for diagnosis of cord accident, based on fetal vascular pathology in the placenta. In the current study, we set out to test sensitivity and specificity of these criteria by reviewing an independent set of stillbirth cases. Methods: Placental slides from 26 cases (where "cord accident" was deemed the cause of death) and 62 controls (where the cause of death was anything other than cord accident) were reviewed. The following histologic changes were noted: 1) dilated fetal vessels; 2) thrombosis in fetal vessels; and 3) avascular or near-avascular chorionic villi. "Minimal" criteria were defined as the presence of dilated and thrombosed fetal vessels, while the additional presence of focal or regional avascular or near-avascular villi satisfied the complete criteria. Results: Of the 62 stillbirth controls with cause of death other than cord accident, 13 (21%) met the minimal criteria (specificity 79%) and only 4 (6%) met the complete criteria for cord accident (specificity 94%). In contrast, of the 26 cases with a cause of death related to cord accident, 16 met the minimal criteria (sensitivity 62%) and 12 met the complete criteria (sensitivity 46%). Conclusions: These histologic criteria identify cases of "cord accident" as a cause of stillbirth with very high specificity. This study confirms the utility of these criteria for diagnosis of cord accident and further stresses placental examination in evaluation of stillbirths.
Authors:
William D Ryan; Neha A Trivedi; Kurt Benirschke; Daphne Yvette Lacoursiere; Mana Parast
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-8
Journal Detail:
Title:  Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society     Volume:  -     ISSN:  1093-5266     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9809673     Medline TA:  Pediatr Dev Pathol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
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