Accuracy of fetal death reports: comparison with data from an independent stillbirth assessment program

We evaluated the completeness and accuracy of reporting on Wisconsin fetal death report forms (FDF) through case by case comparison with data from the Wisconsin Stillbirth Service Project (WiSSP), which uses extensive protocols for etiologic investigation of stillborns. Fetal deaths are underreported: no FDF was submitted for 17.8 per cent of fetal deaths evaluated through the WiSSP. For those for whom FDF were submitted, fetal anomalies were often unrecognized or unreported: only 60 per cent of stillborns identified by the WiSSP as having fetal anomalies had any indication of the presence of such anomalies on FDF. When causes of death were classified into fetal, placental/cord, maternal/environmental, and unknown, comparison of reported underlying cause of death revealed marked inaccuracies on FDF. Placental/cord causes reported on FDF often could not be documented subsequently while, in contrast, fetal causes of death were underreported. Few accurate fetal diagnoses were present on FDF. Even among common lethal malformations misdiagnosis occurred frequently.