66 CASES OF INTRAUTERINE FETAL DEATH - A PROSPECTIVE-STUDY WITH AN EXTENSIVE TEST PROTOCOL

Background. A prospective study was performed to elucidate the etiolog y of intrauterine fetal death and to evaluate diagnostic procedures. M ethods. Sixty-six stillbirth cases with a gestational age of more than 25 complete weeks were studied, using an extensive test protocol. The validity of the cause of death was classified as certain, probable, p ossible and unexplained. The extent to which the diagnostic measures h ad been performed was classified: patients in whom none or only a few tests were performed, patients partially tested and patients completel y tested. Results. The cause of death was certain in 57%, probable in 20%, and possible in 11% of the cases. In only 12% of the cases did th e cause of death remain entirely unexplained. The principal causes of IUFD were infections, including premature rupture of the membranes (15 %), anomalies (11%), preeclampsia-associated conditions (9%) and intra uterine growth retardation of unknown etiology (8%). In this series, l ess well-known conditions, such as circulating maternal autoantibodies and fete-maternal transfusion, also appeared to play an important rol e in causing intra-uterine fetal death. Conclusions. An extensive and relevant test protocol provides information as to the cause of death i n the majority of cases. Future protocols should include tests for aut oimmune antibodies and fete-maternal transfusion.