WISCONSIN STILLBIRTH SERVICE PROGRAM .1. ESTABLISHMENT AND ASSESSMENTOF A COMMUNITY-BASED PROGRAM FOR ETIOLOGIC INVESTIGATION OF INTRAUTERINE DEATHS

Although stillbirth is a common event, few programs have previously be en established for the comprehensive etiologic investigation of intrau terine death. Fewer still have been prospective, unbiased in ascertain ment, and consistent in protocol utilization. The Wisconsin Stillbirth Service Program was established in 1983 as a unique model for the inv estigation of the causes of stillbirth. This community-based, Universi ty-supported model for health care delivery is here described. Through it more than a thousand infants have been etiologically investigated. We demonstrate that a community-based program of stillbirth assessmen t can succeed, that compliance with recommended protocols is high and that a specific primary cause of fetal death can be demonstrated in ab out 40% of referrals. A majority of the established causes of intraute rine death are fetal etiologies. Furthermore, it appears that there ar e no substantial referral biases. Lack of such biases, together with t he prospective, protocol driven nature of the program provides a uniqu e population upon which to base estimates of the frequency of various etiologic diagnoses and classes and categories of cause. (C) 1994 Wile y-Liss, Inc.