Fetal death. A 10-year retrospective study

Area of Science:

• Forensic Pathology
• Perinatal Medicine
• Public Health

Background:

• Fetal death, defined by WHO, has seen reduced incidence for causes like syphilis and diabetes.
• However, intrauterine infections, malformations, growth retardation, and abruptio placentae persist as significant causes.
• Unexplained fetal death and contributing maternal/sociodemographic factors remain critical considerations.

Purpose of the Study:

• To analyze factors contributing to fetal demise in forensic autopsy cases.
• To identify specific causes and risk factors associated with fetal death.
• To improve data collection and classification for better understanding of fetal loss.

Main Methods:

• Retrospective review of 42 forensic autopsy cases of fetal death/stillbirth (1990-1999).
• Analysis included gestational age, sex, race, weight, prenatal care, maternal drug use, autopsy findings, and cause/manner of death.
• Toxicologic analysis was performed on relevant cases.

Main Results:

• The study population had a black:white ratio of approximately 2:1 and a male:female ratio of 1:1.
• Most fetuses were >20 weeks gestational age; 7.5% had congenital anomalies.
• Toxicologic analysis revealed drug use in 21% of cases, including cocaine/benzoylecgonine in 17%.

Conclusions:

• Fetal death remains a complex issue with multifactorial causes, including maternal drug use.
• Lack of uniform data collection hinders comparisons and understanding of fetal death causes.
• This retrospective study aims to assist death investigators in determining factors leading to fetal demise.