Evidence map›Paper›PMID 31888538›Full record

ArticleBMC pregnancy and childbirth2019

Sudden intrauterine unexplained death: time to adopt uniform postmortem investigative guidelines?

Anna M Lavezzi, Francesco Piscioli, Teresa Pusiol, Gianfranco Jorizzo, Stefano Ferrero

Abstract read
In one paragraph

Article in BMC pregnancy and childbirth, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Harmful Effect of Intrauterine Smoke Exposure on Neuronal Control of "Fetal Breathing System" in Stillbirths.International journal of environmental research and public health · 2022
    Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Anna M Lavezzi"Lino Rossi" Research Center for the study and prevention of unexpected perinatal death and SIDS, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 19, 20122, Milan, Italy. anna.lavezzi@unimi.it.ORCID http://orcid.org/0000-0002-0377-5245
Francesco PiscioliInstitute of Pathology, Hospital of Rovereto (Trento), Rovereto, Italy.
Teresa PusiolInstitute of Pathology, Hospital of Rovereto (Trento), Rovereto, Italy.
Gianfranco JorizzoPrenatal Medicine Service, Aulss 6 Euganean Territory, Padua, Italy.
Stefano Ferrero"Lino Rossi" Research Center for the study and prevention of unexpected perinatal death and SIDS, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 19, 20122, Milan, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWorldwide approximately 2.6 million are stillborn, mostly occurring in developing countries. In the great part these deaths are inexplicable. The evenness and standardisation of the diagnostic criteria are prerequisites to understand their pathogenesis. The core goal of this article is to propose new evidence based investigative post-mortem guidelines that should be adopted in all the Institutions especially when a fetal death, after a routine autopsy procedure, is diagnosed as "unexplained". The proposed protocol is mainly focused on the anatomopathological examination of the autonomic nervous system and in particular of the brainstem where the main centers that control vital functions are located.

methodsUpdated investigative guidelines for the examination of unexplained stillbirths, prevalently focused on the histological examination of the brainstem, where the main centers that are involved in monitoring the vital functions are located, are here presented. A section of this protocol concerns the Immunohistochemical evaluation of specific functional markers such as the neuronal nuclear antigen, nicotinic acetylcholine receptors, serotonin, orexin, apoptosis and gliosis. The important role of risk factors, having regard in particular to maternal smoking and air pollution is also contemplated in these guidelines.

resultsSpecific morphological and/or functional alterations of vital brainstem structures have been found with high incidence in over 100 cases of unexplained fetal death sent to the "Lino Rossi Research Center" of the Milan University according to the Italian law. These alterations were rarely detected in a group of control cases.

conclusionsWe hope this protocol can be adopted in all the Institutions notably for the examination of unexplained fetal deaths, in order to make uniform investigations. This will lead to identify a plausible explanation of the pathogenetic mechanism behind the unexplained fetal deaths and to design preventive strategies to decrease the incidence of these very distressing events for both parents and clinicians.

trial registrationnot applicable for this study.

Indexed as

Practice Guidelines as TopicAutopsyFemaleFetal DeathHumansPregnancyStillbirthBrainstemEndocrine disrupting compounds (EDCs)Fetal autopsyGuidelinesImmunohistochemistryNeuropathological protocolNicotineUnexplained stillbirth

Identifiers

PMID31888538
PMCPMC6936151

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.