Abstract

Audit and classification of stillbirth is an essential component of clinical practice and a crucial step in stillbirth prevention. Finding a cause of death in stillbirth is hugely important for parents and clinicians alike. We aimed to examine the rates of unexplained stillbirth between 2008 and 2014 in a large tertiary maternity hospital. We conducted a detailed chart review of all stillbirths, recording data on postmortem, placental histology, cytogenetic reports as well as information from Perinatal Mortality meetings (MDT). We assessed the effect of the implementation of the standardised investigation of stillbirth cases and the appointment of a perinatal pathologist (in 2012). We analysed 252 cases of stillbirth over the 7-year period. The cause of stillbirth was unexplained in 23% of cases (n = 58). A significant decrease in cases of unexplained stillbirths was observed (27.1%; P < 0.001) whereby 34% (n = 51) were classified as unexplained between 2008–2011 and only 6.9% (n = 7) were classified as unexplained between 2012 and 2014. International literature suggests that a third of stillbirths are classified as unexplained. Our study illustrates that clinical-pathological correlation and discussion at MDT meetings improves stillbirth classification. Improvements in classification will result in better patient care.