Perinatal Morbidity, Mortality, and Neurodevelopmental Outcomes of Neonates with Fetal Growth Restriction

Objective: This study aimed to assess perinatal morbidity, mortality rates, and neurodevelopmental outcomes in the management of fetal growth restriction (FGR) at a single tertiary institute. Methods: Among 2465 deliveries between 2013 and 2019, 109 cases of FGR were reviewed retrospectively for causes, indications for pregnancy termination, perinatal death, overall neonatal outcomes, and long-term prognosis. Results: Excluding FGR due to congenital anomalies (n = 17), the mortality rate was 3.3% (3/92). One neonate delivered at 23 weeks developed cerebral palsy (1.1%). Retinopathy of prematurity occurred in four neonates (4.3%). Neurodevelopmental disorders were present in six neonates (6.5%), all of whom were delivered at 32 - 38 weeks. Significantly lower gestational age at delivery, lower birth weight, and higher umbilical artery resistance indices were observed in neonates with neurodevelopmental disorders. Conclusions: Intact survival before 27 weeks of gestation at delivery with FGR is uncommon. Neurodevelopmental disorders may still develop after delivery at 32 - 38 weeks;consideration should be given to the timing of delivery usingfetal ductus venosus Doppler waveforms measurements to reduce neurodevelopmental disorders.

Increased Mortality Risk in Children with Fetal Alcohol Spectrum Disorders: A Scoping Review

Objective: Fetal Alcohol Spectrum Disorders (FASDs) are common, often undiagnosed, lifelong developmental disorders that result from prenatal alcohol exposure. FASD is present at birth and typically identified around seven years of age. The most severe outcome in cases of FASD is mortality. The purpose of this scoping review is to 1) use a systematic review to provide an estimated mortality proportion for children with FASD, and 2) update a study published in 2014 by reviewing published reports of mortality in individuals diagnosed with FASD. Method: A search of PubMed, CINAHL, and Google Scholar for reports published between 2013 and 2023 on mortality in individuals with FASD. Results: Three population-based studies have reported on all-cause mortality rates, finding a combined mortality rate of 10.9%, a 2.63 fold (95% CI: 2.61 to 2.65) increase in mortality risk over the general population. Since 2016, this review identified only eight new cases meeting the study inclusion criteria. The reported causes of death were five cases of pneumonia, and one case each of failure to thrive and dehydration, intestinal dilatation and asphyxiation caused by overeating due to pica, and acute gastric volvulus. Discussion: While current research suggests a diagnosis of FASD is associated with a 2.6-fold increase in mortality risk, this is likely an underestimation, as most cases of FASD-related mortality go unreported. Globally, about 1 new case is reported every 15 months. However, in the United States alone, between 1752 to 4400 FASD related deaths occur annually. Our review suggests that FASD is rarely identified as a causal or contributing factor in deaths of children and adolescents, resulting in a substantial undercount of FASD-related deaths. Increased attention to the role of FASD in infant and child mortality case reviews, child death review committee reports, and mortality reviews is needed.

Epidemiology of Fetal Death and Analysis of Causes According to CODAC Classification at Amath Dansokho Regional Hospital of Kedougou, Senegal

Objectives: This paper aims to study the epidemiology and causes of fetal deaths in utero at Regional Hospital Amath Dansokho of Kedougou (RHADK). Methodology: This was a retrospective epidemiological study conducted at the Maternity Ward of the Regional Hospital Amath Dansokho of Kedougou from June 01, 2022 to June 30, 2023, including all patients seen for delivery care. Data were analyzed using Statistical Package for Social Science (SPSS 22, Windows version). The parameters studied were the frequency of in-utero fetal death, sociodemographic characteristics, pregnancy and delivery data, neonatal data and cause-of-death classification according to the Cause of Death and Associated Conditions (CODAC) classification. Results: We recorded 1628 deliveries, with 231 cases of in-utero fetal death, a frequency of 14.2%. Fetal death occurred most frequently in multiparous women (64.5%). The majority of patients (72.3%) were transferred. 51.9% of patients with fetal death had at least 3 antenatal visits. On admission, fetal heart rate was absent in 73.2% of patients. The etiology of in-utero fetal death was dominated by maternal factors (high blood pressure, anaemia and diabetes), which accounted for 36.9% of deaths, followed by placental pathologies (retroplacental haematoma) and intrapartum pathologies (uterine rupture, abnormal presentation). Conclusion: In-utero fetal death can be prevented, and is mainly due to direct obstetric complications. The focus should be on the prevention and management of hypertensive disorders and their complications during pregnancy, the fight against anaemia and, above all, the rapid and correct management of dystocia.

Risk factors of intrapartal fetal death in a low-resource setting

Objective: To identify the risk factors of intrapartal fetal death in a tertiary hospital in Yaoundé. Methods: It was a case-control study comparing 53 women who delivered with intrapartal fetal death to 106 women who delivered without intrapartal fetal death, carried out at the Yaoundé Gyneco-Obstetric and Pediatric Hospital, Cameroon. Results: The risk factors of intrapartal fetal death identified at bivariate analysis were: maternal age <20 years (OR = 3.1;CI = 1.1 - 8.3), absence of regular income (OR = 2.4;CI = 1.2 - 4.7), single motherhood (OR = 2.9;CI = 1.5 - 5.7), illiteracy and primary level of education (OR = 4.7;CI = 1.9 - 11.5), referral (OR = 5.0;CI = 2.5 - 9.9), parity 0 and 1 (OR = 2.3;CI = 1.1 - 4.5), no antenatal care (OR = 9.2;CI = 2.4 - 35.6), number of antenatal visits <4 (OR = 4.2;CI = 2.1 - 8.6), antenatal care in a health center (OR = 3.8;CI = 1.9 - 7.5), antenatal care by a midwife (OR = 2.5;CI = 1.3 - 4.9) or a nurse (OR = 5.2;CI = 1.4 - 18.7), absence of malaria prophylaxis (OR = 10.6;CI = 2.9 - 39.5), absence of obstetrical ultrasound (OR = 4.7;CI = 1.9 - 10.9), prematurity (OR = 3.4;CI = 1.5 - 7.3), abnormal presentation (OR = 2.6;CI = 1.1 - 5.9), ruptured membranes at admission (OR = 2.7;CI = 1.3 - 5.4), ruptured membranes >12 hours at admission (OR = 5.1;CI = 2.5 - 10.3), stained amniotic fluid (OR = 4.8;CI = 2.4 - 9.7), labor lasting more than 12 hours (OR = 18.1;CI = 8.0 - 41.0), presence of maternal complications (OR = 4.7;CI = 2.2 - 10.3), and presence of fetal complications (OR = 48.6;CI = 18.3 - 129), particularly acute fetal distress (OR = 52.3;CI = (14.6 - 186), cord prolapse (OR = 12.1;CI = 3.3 - 43.4), and birth weight <2500 g (OR = 2.8;CI = 1.2 - 6.6). Conclusion: Close attention should be offered to pregnant women, so as to identify these risk factors and promptly provide an appropriate management.

CONSERVATIVE MANAGEMENT OF TWIN PREGNANCY WITH SINGLE FETAL DEATH

Objective.Analysis of the cause of intrauterine death of one fetus of twin and to evaluate the outcome of conservative management of twin pregnancy with single fetal death. Method.A retrospective review was undertaken on PUMC hospital records of women who delivered twin between Jan. 1987 and Dec. 1998. Result.During the recent 12 years, 99 pregnant women were documented as twin pregnancies. Of the twin pregnancies during this period, 13 were complicated by a single intrauterine death. Four women suffered this complication during their first trimester. In the remain 9 cases one fetus died during second or third trimester. The cesarean section was given in three pregnant women soon after a single intrauterine death because of the survival fetal distress. No consumptive coagulopathy was apparent in all 13 pregnant women. It is wise that the pregnancy was managed conservatively, with regular coagulation parameters obtained. Conclusion.Our results support conservative management in twin pregnancies complicated by single fetal death.

Conditions Associated with Intrauterine Fetal Demise (IUFD) in Pregnant Women at King Abdulaziz University (KAUH). A Five-Year Experience

Background: Intrauterine fetal demise is the death of the fetus after twenty week of gestation but before the onset of labor. In more than 50% of cases, the etiology of antepartum fetal death is not known or cannot be determined. Several factors attributed to the risk of IUFD. This study aimed to determine the incidence of IUFD, as well as associated conditions. Method: This retrospective study enrolled all pregnant women who attending at KAUH between 2011 and 2015. Results: During the last five years 248 verified IUFD cases were reported, the mean age was 30.59. Saudi nationality represented by 27 %. PET was represented 17.7% and congenital malformation was represented by 7.3% as risk factors. Regarding the mode of delivery SVD was 58.9% followed by CS 28.6. Conclusion: Stillbirth is an unfavorable event, there are several factors (maternal, fetal & placenta) associated with IUFD. Providing good level of antenatal care helped in reducing IUFD incidence.

Ontogeny of expression of transforming growth factor-βand its receptors and their possible relationship with scarless or scar-forming healing in human fetal and postnatal skins

Fetal eutaneous wounds that oeeur in earlygestation heal without sear formation.Althoughmueh work has been done to eharaeterize the roleof transforming growth

经羊膜腔穿刺羊水减量对孕产妇羊水过多的疗效及其新生儿死亡影响因素分析

目的分析经羊膜腔穿刺羊水减量术对胎儿消化道畸形合并羊水过多孕产妇的疗效及对新生儿死亡的影响。方法回顾性分析2018年5月—2021年5月确诊为胎儿消化道畸形合并羊水过多的孕产妇及其新生儿的临床资料。根据治疗方法将研究对象分为常规治疗组、利尿剂使用组、经羊膜腔羊水减量组,比较三组孕产妇围产期并发症、分娩方式及妊娠结局,分析新生儿死亡的影响因素。结果纳入胎儿消化道畸形合并羊水过多的孕产妇126例。常规治疗组65例,孕产妇平均年龄(31.0±4.9)岁,首次治疗孕周23~34+6周;利尿剂使用组31例,孕产妇平均年龄(29.3±5.2)岁,首次治疗孕周25~34^(+4)周;经羊膜腔羊水减量组30例,孕产妇平均年龄(31.0±5.3)岁,首次治疗孕周26~34^(+6)周。不同治疗组之间早产、新生儿死亡比例的差异有统计学意义(P<0.05),经羊膜腔羊水减量组的早产率、新生儿死亡比例较低。与存活组相比,死亡组采用剖宫产术以及经羊膜腔羊水减量治疗的比例较低,早产率较高,差异有统计学意义(P<0.05)。采用二分类多因素logistic回归分析发现,早产、常规治疗未行羊水减量术为新生儿死亡的独立危险因素(P<0.05)。结论羊水减量可延长胎儿消化道畸形合并羊水过多孕产妇的孕周,降低早产率,改善新生儿预后。

独眼畸形三倍体死胎一例

独眼畸形通常由于胚胎两眼原基未完全分离或者前脑中部发育障碍,导致两侧原始视泡向中线融合引发,是前脑无裂畸形相关面部畸形中最严重的一种表现。报告1例妊娠16周独眼畸形死胎病例,该例孕妇妊娠14+3周时行胎儿颈后透明层检查发现头颅内异常液性暗区,妊娠终止后引产儿面部可见单眼眶及其上方的前额鼻肉柱,经基因组拷贝数变异测序(copy number variation sequencing,CNV-seq)分析发现染色体三倍体变异、嵌合比约32%的X染色体嵌合重复以及嵌合比约32%的Y染色体嵌合缺失。独眼畸形的病因具有异质性,目前其发病机制尚未明确,妊娠期影像学检查和产前诊断为常用检查方法,在诊断后应尽早终止妊娠,减轻孕妇身心损害及社会医疗经济负担。

早期肿瘤退缩和肿瘤反应深度与PD-1抑制剂联合曲妥珠单抗和化疗一线治疗HER-2阳性晚期胃癌疗效及预后的关系

目的:探索早期肿瘤退缩和肿瘤反应深度与程序性死亡受体-1(programmed death-1,PD-1)抑制剂联合曲妥珠单抗和化疗一线治疗人表皮生长因子受体2(human epidermal growth factor receptor 2,HER-2)阳性晚期胃癌临床疗效及预后的关系。方法:回顾性分析2018年6月至2023年3月就诊于南京大学医学院附属鼓楼医院接受PD-1抑制剂联合曲妥珠单抗和化疗一线治疗的40例HER-2阳性晚期胃癌患者的临床资料,观察指标为早期肿瘤退缩(early tumor shrinkage,ETS)、肿瘤反应深度(depth of response,DpR)、客观缓解率(objective response rate,ORR)、疾病控制率(disease control rate,DCR)、无进展生存期(progression-free survival,PFS)、总生存期(overall survival,OS)和治疗相关不良反应。采用Log-rank检验和Kaplan-Meier法进行生存分析并绘制PFS及OS生存曲线,Cox回归分析进行相关性检验。结果:患者ORR为77.5%,DCR为100%,完全缓解率为15.0%,中位PFS(median PFS,mPFS)为11.10个月,中位OS(median OS,mOS)为30.77个月。Cox单因素分析显示,肿瘤分化程度、肝转移、远处淋巴结转移、DpR与PFS和OS均有关(均P<0.05),ETS仅与PFS有关(P=0.010),PD-L1表达与PFS和OS均无关。ETS≥35%和ETS<35%患者的mPFS有显著性差异(P=0.008),mOS无显著性差异(P=0.076);DpR≥40%和DpR<40%患者的mPFS和mOS均有显著性差异(P=0.001)。Cox多因素分析显示,DpR是影响PFS和OS的独立因素,远处淋巴结转移是影响OS的独立因素。患者总体对治疗耐受性较好,无4级以上治疗相关不良反应或死亡。结论:ETS和DpR可能是PD-1抑制剂联合曲妥珠单抗和化疗一线治疗HER-2阳性晚期胃癌疗效和预后的预测指标。

单绒毛膜双胎之一胎死宫内存活胎脑损伤的研究进展

随着促排卵技术和辅助生殖技术的发展,多胎妊娠率逐年升高。双胎之一胎死宫内(single intrauterine fetal death,sIUFD)是单绒毛膜双胎妊娠中晚期的严重并发症。一胎死亡后,存活胎神经系统受损是影响新生儿及婴幼儿远期预后的重要因素,严重影响人口质量。研究存活胎神经系统受损的机制及有效地监测存活胎可能发生的脑损伤,对预防严重脑损伤并发症至关重要,也是妊娠期管理和分娩时机选择的重要依据。通过识别sIUFD存活胎神经损伤的相关危险因素,采取合适的监测手段和宫内治疗,制定相应的分娩方案,以减少存活胎不良神经结局的发生。

Vaginal Cesarean Section, an Alternative to High-Risk Trigger on Scarred Uterus

The objective is to report a clinical case of vaginal cesarean section performed to expel a dead fetus in scarred uterus. For this indication, vaginal hysterectomy constitutes an alternative to vaginal expulsion with a high risk of uterine rupture and to classic abdominal cesarean section with risk of significant surgical trauma, particularly adhesions. However, this surgical technique, described since the 19th century, remains unknown to many practitioners and few publications exist on the subject throughout the world. Considered obsolete by some practitioners, it retains all its advantages in the practice of modern obstetrics. We report this case of expulsion of fetal death on a tri-scarred uterus performed by vaginal cesarean section at the Health District Reference Health Center (District Hospital) of Commune I in Bamako, Mali in a 37-year-old patient with a pregnancy of 27 weeks of amenorrhea.

Ets-1和MMP-9与亚临床绒毛膜羊膜炎的关系探讨

目的研究Ets-1和MMP-9与亚临床绒毛膜羊膜炎的关系。方法采用免疫组织化学方法检测Ets-1和MMP-9在胎膜早破组及相对应孕周未破膜妊娠组(对照组)胎膜中的表达,同时将所有病例的胎膜进行病理组织学检查。结果 Ets-1和MMP-9在胎膜早破组中的表达明显高于对照组,两者差异有显著意义(P<0.05),而且在发生绒毛膜羊膜炎的研究组中表达更高,两者差异有极显著意义(P<0.01),胎膜早破组中绒毛膜羊膜炎的发生率(68%)明显高于对照组(22.22%)。结论 Ets-1和MMP-9在胎膜早破组中的表达明显增高,其表达程度与感染程度相关。

猪脑死亡对血清ET-1及TNF-α、IL-1β、IL-6表达影响的初步研究

目的:探讨"渐进式"颅内加压法诱导猪脑死亡对血清中ET-1、TNF-α、IL-1β及IL-6表达的影响。方法:雄性长白猪12头,随机分为两组,对照组:颅内置入颅内压探头及水囊导管,但不进行颅内加压;脑死亡组:颅内置入颅内压探头及水囊导管,根据颅内压和平均动脉压的关系,调整加压强度建立脑死亡模型,并通过呼吸、循环维持脑死亡状态12 h,并检测血清ET-1、TNF-α、IL-1β及IL-6水平。结果:脑死亡组ET-1水平从脑死亡0 h即逐渐升高,TNF-α、IL-1β、IL-6从脑死亡后6 h开始升高,上述因子水平与对照组比较,差异均有统计学意义(P<0.05)。结论:脑死亡时TNF-α、IL-1β、IL-6等炎症因子升高相对迟缓,而ET-1水平发生变化较早,灵敏度高,这可能与其作为前炎症介质有关。

F&#339;tal Death in Utero: Maternal Epidemiological and Prognostic Aspects at Sylvanus Olympio Teaching Hospital in Lomé

The fetal death In Uterus is relatively a common problem in developing countries. In Africa, the rate of deaths varies from one hospital to another. We wanted to evaluate the prevalence, to describe the epidemiological aspects, etiologies and maternal prognosis associated with fetal deaths in Uterus in 2017 at Sylvanus Olympio Teaching Hospital in Lomé. Patients and methods: This was a retrospective descriptive study conducted from January 1st to December 31st, 2017. We have included all pregnant cases received and treated on the spot for in uterus deaths as defined by the World Health Organization. Medical termination of pregnancy records, intrapartum deaths, less than 22 amenorrhea weeks’ pregnancies and complications of abortion were not included. Results: The fetal death rate in uterus was 3.64%. The multigravida and multiparous were respectively 49% and 41%;the referees were 51%, 28% evacuated;21% came on their own. The gestational age of 28 - 37 weeks was 39% and 17% had no prenatal consultation. The analysis has revealed that high blood pressure, preeclampsia, and retroplacental hematomas were the main etiologies associated with fetal deaths in uterus. Conclusion: In uterus fetal deaths remain common in our country. The main causes were hypertension disorders of pregnancy. There were also some unknown causes which could be related to economic or cultural reasons. For instance, autopsies of in uterus deaths and placental anatomopathology examination are not performed because of culture.

Severe Trauma of Uterus and the Right Limb during a Road Accident at the Department of Obstetrics and Gynecology of the Teaching Hospital Souro Sanou of Bobo-Dioulasso: A Case Report and Review of Literature

The authors reported a case of trauma with uterus rupture at 35 weeks gestation with fetal death in uterus with a trauma of the right limb injuries during a serious road accident. Aim: the aim is to show the increasing of road accident with the motorized tricycle and their many risks for pregnant woman. Case Presentation: our patient was thrown from the back cargo of a motorized tricycle (three-wheeled vehicle) after a collision with a truck in a rural area from 150 km to Bobo-Dioulasso. She sustained a closed abdominal injury and a severe right lower limb open injury. At admission in our department in the Teaching Hospital, she was conscious, shocked with hemodynamic instability, including low blood pressure (75/52 mmHg), rapid heart rate (140 pulses per minute), rapid breath rate (40 per minute), and cold extremities. Abdominal examination was painful with uterine hypertonia, 28 cm height uterus, and no fetal heart heartbeat. A laparotomy in urgency revealed a rupture of the uterus fundus with a dead fetus. A conservative surgical treatment was performed. An open trauma to the right limb was managed by the orthopedists with a good outcome. Conclusion: Accident trauma during pregnancy is becoming more and more frequent with the increase in means of transport in urban and inter urban areas. The transport ways of the pregnant woman must take into account her safety and that of the fetus.

2 872对不同绒毛膜性双胎子代不良结局差异及影响因素分析

目的探讨不同绒毛膜性双胎子代不良结局发生的差异及其影响因素。方法选择2020年1月1日至12月31日,北京市妇幼保健网络信息系统中登记的2872例双胎妊娠孕妇及其子代为研究对象,所有孕妇均进行了早孕期绒毛膜性超声确认,并有明确妊娠结局。根据超声提示的双胎绒毛膜性将孕妇分为单绒毛膜双胎妊娠组(单绒组,n=642)和双绒毛膜双胎妊娠组(双绒组,n=2230)。比较单绒组和双绒组子代不良结局(<28周流产、围产期死亡、双胎均死亡和出生缺陷等)的差异,对影响单绒组和双绒组子代不良结局差异的影响因素进行多因素分析。结果单绒组和双绒组子代发生<28周流产率(分别为15.0%、9.0%,OR=1.85,95%CI:1.50~2.27)、围产期死亡率(分别为1.0%、0.4%,OR=3.22,95%CI:1.45~7.12)和双胎均死亡率(分别为12.0%、4.6%,OR=2.71,95%CI:1.91~3.83)的风险高于双绒组子代;子代不同孕周死亡风险由高到低依次为孕14~27周、孕14周前、孕28~33周和孕≥34周,单绒组子代死亡风险均高于双绒组。单绒组子代出生缺陷发生风险高于双绒组但差异无统计学意义(7.3%比6.7%,OR=1.04,95%CI:0.80~1.35)。结论单绒双胎妊娠在子代流产、围产期死亡和双胎均死亡的风险均高于双绒双胎妊娠,早孕期开始超声筛查确定绒毛膜性、中孕期加强定期检查和胎儿畸形筛查、晚孕期持续加强对每一个胎儿的关注并适时终止妊娠,对于改善双胎子代结局有积极意义。

经肝动脉化疗栓塞联合程序性死亡受体1抑制剂治疗晚期肝癌的临床研究

目的 探讨经肝动脉化疗栓塞(transhepatic arterial chemoembolization,TACE)联合程序性死亡受体1(programmed deathreceptor1,PD-1)抑制剂治疗晚期肝癌的临床疗效。方法 选择2020年4月至2022年1月甘肃省肿瘤医院收治的80例晚期肝癌患者,采用随机数字表法分为两组,每组40例。对照组采用TACE治疗,观察组采用TACE联合PD-1抑制剂治疗。比较两组的实体瘤疗效、安全性、生存时间,以及治疗前和治疗2个周期后血清血管内皮生长因子(vascular endothelial growth factor,VEGF)、甲胎蛋白(alpha fetal protein,AFP)水平。结果 观察组疾病控制率(75.00%)高于对照组(52.50%),差异有显著性(P<0.05)。两组治疗2个周期后血清VEGF、AFP水平均较治疗前降低,且观察组低于对照组,差异有显著性(P<0.05)。两组Ⅲ度及以上不良反应发生率比较差异无显著性(P>0.05)。80例患者的随访时间为13(1,22)个月,观察组无进展生存时间为7(5,13)个月,长于对照组的5(3,10)个月,差异有显著性(P<0.05)。观察组总生存时间为15(15,22)个月,与对照组的14(13,21)个月比较差异无显著性(P>0.05)。结论 TACE联合PD-1抑制剂治疗晚期肝癌可降低血清VEGF和AFP水平,提高疾病控制率,延长无进展生存时间,且安全性可控。

妊娠晚期胎死宫内的临床分析及风险预测

目的 分析妊娠晚期胎死宫内的危险因素及围产结局,构建并验证列线图风险预测模型。方法 选取妊娠晚期胎死宫内患者69例为病例组,另取同期正常分娩的孕妇69例为对照组。比较患者一般情况、母体因素、胎儿因素、胎儿附属物因素、围产结局等临床资料。采用Logistic回归分析妊娠晚期发生胎死宫内的危险因素,建立风险预测列线图模型,并使用Bootstrap法进行内部验证,计算C统计量(C-Statistic),Hosmer-Lemeshow检验评模型的拟合优度。结果病例组年龄高于对照组,产检次数少于对照组(P<0.05),非高等教育背景、非中心城区居住、无业、高龄(≥35岁)、经产妇、自觉胎动异常、子痫前期、双胎妊娠、宫内感染、胎儿系统超声异常、染色体异常、小于胎龄儿、脐带异常、羊水量异常、早产、经阴道分娩的比例均高于对照组(P<0.05)。Logistic回归分析显示,自觉胎动异常、子痫前期、双胎妊娠、胎儿系统超声或染色体异常、脐带或羊水量异常为发生妊娠晚期胎死宫内的独立危险因素,高产检次数为其保护因素(P<0.05)。基于多因素Logistic回归分析结果,结合临床实际情况将年龄同时纳入预测模型,建立列线图风险预测模型,Bootstrap内部验证和Hosmer-Lemeshow检验结果显示模型区分度(C-Statistic=0.937)和校准度良好(χ^(2)=5.364,P=0.643)。结论 构建的列线图模型可有效评估发生妊娠晚期胎死宫内的风险,具有良好的临床应用价值。