Assigning Cause of Stillbirth: Comparison of Two Methods

Abstract

Background: Stillbirth, defined as the death of a fetus after 20 weeks of gestation and before or during labor, remains a significant public health challenge. Identifying the cause of stillbirth is crucial for improving maternal and fetal health outcomes. Several methods exist for determining the cause of stillbirth, each with its strengths and limitations. This study aims to compare two commonly used methods of assigning the cause of stillbirth: the clinical diagnosis method and the post-mortem examination (autopsy) method.

Methods: A total of 100 stillbirths were analyzed, using both clinical diagnosis and autopsy to assign a cause. The clinical diagnosis method involved a detailed maternal history, physical examination, ultrasound findings, and labor records, while the autopsy included histopathological examination, placental pathology, and microbiological studies. The causes of stillbirth assigned by both methods were compared for consistency.

Results: The study found that the clinical diagnosis method and the autopsy method were in agreement in 70% of cases. However, the autopsy method revealed additional findings that were not identified through clinical assessment, including infections, umbilical cord abnormalities, and placental insufficiency. The autopsy method was more comprehensive in identifying the underlying causes of stillbirth.

Conclusion: Both clinical diagnosis and autopsy are valuable tools in assigning the cause of stillbirth, but autopsy provides more detailed information and should be considered essential in stillbirth investigations. Enhanced training in post-mortem procedures and increased acceptance of autopsies can improve stillbirth cause assignment and help develop strategies to prevent future occurrences.

Keywords: Stillbirth, cause of stillbirth, clinical diagnosis, autopsy, post-mortem examination, fetal death.