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Evaluation of stillbirth

Author
Drucilla J Roberts, MD
Section Editor
Charles J Lockwood, MD, MHCM
Deputy Editor
Vanessa A Barss, MD, FACOG

INTRODUCTION

Following a stillbirth, both laboratory testing and gross and microscopic evaluation of the placenta and fetal tissues are important for determining the cause of death. Despite a comprehensive examination, however, a minority of parents will still be left without a definitive reason for their child's demise.

Procedures for evaluation of the stillborn will be reviewed here. The incidence, etiology, prevention, and management of antepartum fetal death and counseling parents after stillbirth are discussed separately. (See "Fetal death and stillbirth: Incidence, etiology, and prevention" and "Fetal death and stillbirth: Maternal care".)

MATERNAL LABORATORY EVALUATION

The optimal laboratory evaluation of women who have had a stillbirth is controversial. Many lists have been proposed, but the most cost-effective approach has not been determined [1-10]. Our approach is guided by clinical, sonographic, and histopathologic findings.

The author orders or reviews recent tests results for:

Fetomaternal hemorrhage (eg, Kleihauer-Betke test, flow cytometry) in all women who have an unexplained stillbirth since detection of a large fetomaternal hemorrhage may explain the cause of an otherwise unexplained fetal demise [11]. (See "Massive fetomaternal hemorrhage".)

                 

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Literature review current through: Nov 2016. | This topic last updated: Tue Nov 29 00:00:00 GMT 2016.
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