Clinicopathological evaluation of 59 cases of fetal death.

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.