Clinicopathological evaluation of 59 cases of fetal death

Arch Gynecol Obstet. 2007 Dec;276(6):619-23. doi: 10.1007/s00404-007-0391-8. Epub 2007 May 31.

Abstract

Objective: The purpose of this study has been assessing the determinants of stillbirth among the newborns of the Verona University Obstetrics Department.

Materials and methods: A total of 59 stillbirth cases, observed between January 2000 and June 2006, were retrospectively studied. WHO definition for stillbirth was adopted as the inclusion criterion. Clinical files, feto-maternal laboratory data, feto-placental pathology findings as well as delivery mode and circumstances were all systematically reviewed.

Results: The 59 observed cases correspond to an incidence of 9.8 stillbirths/year, which, considering the institutional delivery rate, correspond to 5.4 cases per 1000 births. Frequent relevant conditions associated with stillbirth were intrauterine growth restriction (15.2%), congenital fetal anomalies (13.5%), various maternal diseases (21.0%); no cause of fetal demise could be found in 10/59 (17.0%) cases, which were classified as unexplained. Most deliveries were successfully induced with prostaglandins except 11 cases (19.0%) which required a C-section due to severe maternal conditions associated with the fetal loss.

Conclusion: Thorough investigation of each individual stillbirth case, by means of an integrated study protocol, along with the Pathologist's close collaboration, allows identification of a likely cause in the majority of cases. Better knowledge of unexpected fetal loss is the premise for better parental counselling and for prevention of recurrences.

MeSH terms

  • Adolescent
  • Adult
  • Cause of Death
  • Female
  • Fetal Death / epidemiology
  • Fetal Death / etiology*
  • Gestational Age
  • Hospitals, University / statistics & numerical data
  • Humans
  • Incidence
  • Italy / epidemiology
  • Pregnancy
  • Retrospective Studies
  • Stillbirth / epidemiology*