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Chromosomal anomalies
Non chromosomal birth defect
Non immune hydrop
Infection (virus, bacteria, protozoa)
Placental
(25-35%)
Maternal
(5-10%)
Unexplained
(25-35%)
Fetal causes
The incidence of major congenital
malformation in stillborn is highly variable
1/3 of fetal death were causes by structural
anomalies of
Neural-tube defects
Hydrops
Isolated hydrocephalus
Complex congenital heart disease
were the most common
Fetal causes
The incidence of stillbirths cause by fetal
infection appear to be remarkably consistent
Most were diagnosed as chorioamnionitis and
fetal or intrauterine sepsis
Congenital syphilis can be a common cause of
fetal death
Other potential infection : CMV, parvovirus B19,
rubella, varicella and listeriosis
Placental causes
Placental abruption
The most common single identifiable cause of
fetal death
Associated with gestational hypertension in a
half of casess
Placental causes
Placental infarcts
Areas of fibrinoid trophoblastic degeneration,
calcification and ischemic infarction from
spiral artery occlusion
Causes from severe hypertension or
preeclampsia
Fetal-maternal hemorrhage
Common with severe maternal trauma
Twin-to-twin transfusion in monochorionic
Maternal causes
Hypertensive disorder and diabetes are the two
most commonly cited maternal disease
Lupus anticoagulant and anticardiolipin
antibodies are associated with decidual
vasculopathy, placental infarction, fetal growth
restriction, recurrent abortion and fetal death
Some hereditary thrombophilias linked with
placental abruption and fetal growth restriction
Autopsy
A gross external examination, along with
photography, radiography, MRI, bacterial
culture, and selective use of chromosomal
and histopathology studies can often
determine the cause of death
Parents should be contact and offered
counseling regarding cause of death, to
avoid recurrent in future pregnancy
Psychological aspect
Fetal death is psychologically traumatic for
the woman and her family
Stress result from an interval of more than
24 hr between the diagnosis of fetal death
and the induction of labor
The woman is at increase risk for
postpartum depression and should be
closely monitored