title: Late stillbirth: a ten year cohort study.
abstract: BACKGROUND
  Late fetal death is a desolating event that inspite the effort to implement new surveillance protocols in perinatal continues to defy our clinical pratice.
  
  
  OBJECTIVE
  To examine etiological factors contributing to main causes and conditions associated with fetal death in late pregnancies over a 10-year period.
  
  
  METHODS
  Retrospective cohort analysis of 208 late singleton stillbirth delived in a tertiary-perinatal referral maternity over a 10-year period. Clinical charts, laboratory data and feto-placental pathology findings were systematically reviewed.
  
  
  RESULTS
  The incidence of late fetal demise was 3.5 per 1000 pregnancies. No significant trend in the incidence of stillbirth was demonstrated during the study period. Stillbirth was intrapartum in 12 (5.8%) cases and 72 (35%) were term pregnancies. Fourteen percent of cases were undersurveilled pregnancies. Mean gestacional age at diagnosis was 34 weeks. The primary cause of death was fetal, it was present in 59 cases, 25% were considered small for gestational age. Stillbirths were unexplained in 24.5% of cases. Maternal medical disorders were identified in 21%. Hypertensive disorders were frequent and associated with early gestacional age (p = 0.028).
  
  
  CONCLUSIONS
  There was no change in the incidence of late stillbirth during the 10 years under evaluation. The incidence was 3.5 ‰ which was identical to that described in developed countries. About one quarter of the stillbirths was unexplained. The most frequent maternal pathology was chronic hypertension.
authors.affiliation: Department of Obstetrics and Gynecology, Alfredo da Costa Maternity, Lisbon, Portugal.
authors.forename: Raquel
authors.initials: R
authors.lastname: Robalo
authors.forename: Célia
authors.initials: C
authors.lastname: Pedroso
authors.forename: Njila
authors.initials: N
authors.lastname: Amaral
authors.forename: Clara
authors.initials: C
authors.lastname: Soares
mesh_terms: D015331:Cohort Studies; D005313:Fetal Death / Q000453:epidemiology* / Q000209:etiology*; D005865:Gestational Age; D006801:Humans; D012189:Retrospective Studies; D050497:Stillbirth / Q000453:epidemiology*; D013997:Time Factors