Abstract

Stillbirth is defined as infants born after 24 weeks of gestation and weighing >500 g, showing no signs of life. An unexplained stillbirth may simply be an uninvestigated one, and finding a cause is hugely important for parents and clinicians. Perinatal pathology provides valuable information in determining the cause of stillbirth, through specialised examinations on the infant and placenta. We aimed to demonstrate the impact of perinatal pathology in determining cause of death in stillbirths in a university teaching hospital delivering over 8000 infants annually. A perinatal pathologist was appointed in 2012. All stillbirths from 2008 to 2014 were identified (n=259). From 2008 to 2014 the uptake rate of perinatal postmortems increased by 27% with a corresponding decrease of 39% in unexplained stillbirths. In 2008, 2010 and 2012 the rates of postmortems performed were 56%, 51% and 53%, respectively with an increase to 77% in 2014. Overall, 26% of stillbirths were unexplained; although 36% of these had no postmortem examination. By 2014 only 5% of stillbirths were categorised as unexplained. With specialist pathology services available since 2012 and an increase in postmortem investigations, there has been a significant decrease in the number of stillbirths whose cause of death is unexplained.