Preventing Stillbirth:A Review of Screening and Prevention Strategies  

作　　者：Laure Noël Conrado Milani Coutinho Basky Thilaganathan 

机构地区：[1]Department of Obstetrics and Gynecology,Centre Hospitalier Universitaire de Liège,4000 Liège,Belgium [2]Department of Gynecology and Obstetrics,Hospital das Clínicas,Faculdade de Medicina de Ribeirão Preto,Universidade de São Paulo,Ribeirão Preto,SP,14025-000,Brazil [3]Fetal Medicine Unit,St George’s University Hospitals NHS Foundation Trust,Blackshaw Road,London,SW170QT,United Kingdom.

出　　处：《Maternal-Fetal Medicine》2022年第3期218-228,共11页母胎医学杂志（英文）

摘　　要：Stillbirth is a devastating pregnancy complication that still affects many women,particularly from low and middle-income countries.It is often labeled as“unexplained”and therefore unpreventable,despite the knowledge that placental dysfunction has been identified as a leading cause of antepartum stillbirth.Currently,screening for pregnancies at high-risk for placental dysfunction relies on checklists of maternal risk factors and serial measurement of symphyseal-fundal height to identify small for gestational age fetuses.More recently,the first-trimester combined screening algorithm developed by the Fetal Medicine Foundation has emerged as a better tool to predict and prevent early-onset placental dysfunction and its main outcomes of preterm preeclampsia,fetal growth restriction and stillbirth by the appropriate use of Aspirin therapy,serial growth scans and induction of labour from 40 weeks for women identified at high-risk by such screening.There is currently no equivalent to predict and prevent late-onset placental dysfunction,although algorithms combining an ultrasound-based estimation of fetal weight,assessment of maternal and fetal Doppler indices,and maternal serum biomarkers show promise as emerging new screening tools to optimize pregnancy monitoring and timing of delivery to prevent stillbirth.In this review we discuss the strategies to predict and prevent stillbirths based on firsttrimester screening as well as fetal growth and wellbeing assessment in the second and third trimesters.

关 键 词：Biomarkers Fetal growth restriction Placental dysfunction PREVENTION SCREENING STILLBIRTH 

分 类 号：R714.5[医药卫生—妇产科学]