{"id":526,"date":"2023-04-30T16:04:51","date_gmt":"2023-04-30T14:04:51","guid":{"rendered":"https:\/\/www.fondazione.ciaolapo.it\/2023\/04\/30\/recommendations-on-the-management-of-fetal-endouterine-death\/"},"modified":"2026-04-30T16:29:00","modified_gmt":"2026-04-30T14:29:00","slug":"recommendations-on-the-management-of-fetal-endouterine-death","status":"publish","type":"post","link":"https:\/\/www.fondazione.ciaolapo.it\/en\/2023\/04\/30\/recommendations-on-the-management-of-fetal-endouterine-death\/","title":{"rendered":"Recommendations on the management of fetal endouterine death"},"content":{"rendered":"

On February 7, 2023<\/strong>, the Recommendations on the Management of Fetal Endouterine Death (FEM)<\/strong> were published, a document that has been awaited for many years and is destined to become the Italian reference for professionals assisting women, couples and families affected by in utero death<\/strong>. The document, titled “Management of Endouterine Fetal Death (MEF). Taking care of stillbirth,”<\/em> was drafted by the Confalonieri Ragonese Foundation<\/strong> on behalf of the three main scientific societies of Italian gynecology, SIGO, AOGOI and AGUI<\/strong>, and brings together in 132 pages the first organic body of national guidance on the topic, built on the adaptation of the main international guidelines (Queensland, PSANZ, SOGC, ACOG-SMFM) to the care, regulatory and cultural context of our country. <\/p>\n

For our Foundation, this is particularly important news, not only because of the importance of the document itself, but because CiaoLapo took part in the drafting<\/strong> of the text: Prof. Alfredo Vannacci<\/strong>, vice president of the Foundation and head of the PeaRL Joint Perinatal Research Laboratory<\/a> at the University of Florence, was among the document’s drafters<\/strong>, in a multidisciplinary working group of more than forty Italian professionals including gynecologists, obstetricians, neonatologists, anatomopathologists, epidemiologists and clinical psychologists.<\/p>\n

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Why these recommendations were necessary<\/h2>\n

Stillbirth<\/strong> is one of the most relevant health indicators of a population, and it is one of the most common adverse outcomes of pregnancy: it occurs in about 1 in every 200-300 deliveries<\/strong> in industrialized countries, with an Italian prevalence estimated at around 3-4 cases per 1000 births<\/strong>. It is an event whose frequency is often underestimated, but whose impact, emotionally and psychotraumatologically, is devastating for the couples and health care providers involved. <\/p>\n

Despite the magnitude of the phenomenon, Italy has been in a paradoxical position to date: The Lancet<\/em> ‘s latest series on stillbirth, Ending preventable stillbirths<\/em><\/a>, conducted in 2016 with the participation of Claudia Ravaldi<\/strong> and Alfredo Vannacci<\/strong> of CiaoLapo<\/strong>, had in fact documented that our country was unable to provide information on causes of death in more than 50 percent of late stillbirths<\/strong> (after 28 weeks). The lack of uniform protocols for the evaluation and classification of stillbirths, coupled with the poor performance of key investigations (primarily autopsy and histological examination of the placenta), has long limited the possibility of understanding, and thus preventing, these events. The publication of shared National Recommendations is therefore, first and foremost, an act of responsibility to families and to the system of care. <\/p>\n

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The key points of the document<\/h2>\n

The Recommendations are divided into ten chapters covering the entire care pathway, from diagnosis to follow-up, and are accompanied by an operational<\/strong> summary summarizing their essential contents. We report here the passages that we consider most significant, with particular attention to aspects that intersect the work of our Foundation. <\/p>\n