title: Evaluation of 1025 fetal deaths: proposed diagnostic workup.
abstract: OBJECTIVE
  We sought to evaluate the contribution of different diagnostic tests for determining cause of fetal death. Our goal was to propose a workup guideline.
  
  
  METHODS
  In a multicenter prospective cohort study from 2002 through 2008, for 1025 couples with fetal death ≥20 weeks' gestation, an extensive nonselective diagnostic workup was performed. A panel classified cause and determined contribution of diagnostics for allocating cause.
  
  
  RESULTS
  A Kleihauer-Betke, autopsy, placental examination, and cytogenetic analysis were abnormal in 11.9% (95% confidence interval [CI], 9.8-14.2), 51.5% (95% CI, 47.4-55.2), 89.2% (95% CI, 87.2-91.1), and 11.9% (95% CI, 8.7-15.7), respectively. The most valuable tests for determination of cause were placental examination (95.7%; 95% CI, 94.2-96.8), autopsy (72.6%; 95% CI, 69.2-75.9), and cytogenetic analysis (29.0%; 95% CI, 24.4-34.0).
  
  
  CONCLUSIONS
  Autopsy, placental examination, cytogenetic analysis, and testing for fetal maternal hemorrhage are basic tests for workup after fetal death. Based on the results of these tests or on specific clinical characteristics, further sequential testing is indicated.
authors.affiliation: Department of Obstetrics and Gynecology, University Medical Centre Groningen, University of Groningen, The Netherlands. f.j.korteweg@og.umcg.nl
authors.forename: Fleurisca J
authors.initials: FJ
authors.lastname: Korteweg
authors.forename: Jan Jaap H M
authors.initials: JJ
authors.lastname: Erwich
authors.forename: Albertus
authors.initials: A
authors.lastname: Timmer
authors.forename: Jan
authors.initials: J
authors.lastname: van der Meer
authors.forename: Joke M
authors.initials: JM
authors.lastname: Ravisé
authors.forename: Nic J G M
authors.initials: NJ
authors.lastname: Veeger
authors.forename: Jozien P
authors.initials: JP
authors.lastname: Holm
mesh_terms: D000293:Adolescent; D000328:Adult; D001344:Autopsy; D002423:Cause of Death; D015331:Cohort Studies; D020732:Cytogenetic Analysis; D005260:Female; D005313:Fetal Death / Q000175:diagnosis*; D006801:Humans; D008875:Middle Aged; D010920:Placenta / Q000002:abnormalities; D010922:Placenta Diseases / Q000175:diagnosis; D011247:Pregnancy; D011446:Prospective Studies; D050497:Stillbirth; D055815:Young Adult