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Reinvestigating unexplained stillbirths for evidence of phasic uteroplacental hypoperfusion and its clinical associations

About Course

Stillbirths are a devastating tragedy. Although fetal autopsies and placental pathologies may yield diagnostic information regarding the cause, between 10-50% of stillbirths remain underexplained or unexplained. Based on our hypothesis that some unexplained stillbirths occur due to repetitive uteroplacental hypoperfusion during periods of maternal supine sleep, we conducted a retrospective review of 17 years of stillbirth fetal autopsies, placental pathology, and maternal clinical histories to determine the correlation between clinical risk factors for increased maternal venous pressure when supine and phasic-type neuropathological findings associated with uteroplacental hypoperfusion.

What I will learn?

  • At the conclusion of this activity participants will be able to:
  • Ynderstand why increased maternal venous pressures may occur while supine, how this may affect uteroplacental perfusion vis-a-vis the organ perfusion pressure equation, and why avoiding supine positioning may be especially important in patients with certain clinically identifiable features (e.g., obesity, polyhydramnios, obstructive sleep apnea).
  • Understand the clinical significance of pontosubicular neuronal necrosis (PSN), which is indicative of survivable hypoxic ischemic brain injury that would have occurred approximately 12-24 hours prior to death due to uteroplacental hypoperfusion. Presumably, the insulting event reoccurred and led to fetal demise due to recurrent uteroplacental hypoperfusion episodes associated with the clinically identifiable features, and thus represents evidence of a clinically relevant process that may be modifiable.

Course Curriculum

Reinvestigating unexplained stillbirths for evidence of phasic uteroplacental hypoperfusion and its clinical associations

  • Video Lecture
  • Post-test
  • Activity Evaluation

Student Ratings & Reviews

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Target Audience

  • Physicians, Midwives, Nurses, Case Managers, Sonographers, Childbirth Educators
Continuing Education Credit

NURSES: This nursing continuing professional development activity was approved by the Colorado
Nurses Association, an accredited approver by the American Nurses Credentialing Center’s
Commission on Accreditation. .5 contact hours will be awarded upon completion of course activity, post-test and evaluation.

SOCIAL WORKERS: Star Legacy Foundation is an approved provider of continuing education for
social workers. Social workers can claim up to .5 hour of continuing education for participation in
this activity and completion of the evaluation form.

PHYSICIANS: This activity has been planned and implemented in accordance with the Essential
Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint
providership of the University of California San Diego and the Star Legacy Foundation.

The University of California San Diego is accredited by the Accreditation Council for Continuing
Medical Education to provide continuing education for physicians. The Minnesota Medical
Association designates this live activity for a maximum of .5 AMA PRA Category 1
Credit(s). Physicians should only claim the credit commensurate with their participation in the