111 stillbirths were recorded in the ten year period from 2003 to 2012. The rate of stillbirths for this District General Hospital was 3.5 per 1000. Equal amounts were considered low risk, receiving MLC, to high risk. 56% had had at least one previous delivery with the mode being a parity of one. The ranges for maternal age and BMI were wide, with the mean 30 and 27 respectively. Majority of stillbirths occurred less than 37 weeks (58%), nearly a third below 28 weeks. Twin pregnancies accounted for 6% of the stillbirths.
95% of stillbirths were in the antenatal period, 4 of the 5 intrapartum stillbirths occurred after 39 weeks. A third of the stillbirths were found to be growth restricted. Karyotype analysis was accepted in 97% of cases and was found to be abnormal in 6%. 60% of patients declined post mortem examination adding pressure for answers to be found from the remaining investigations. Thrombophilia results were abnormal in 10% of cases while TORCH screen picked up only 2 infections. Of the 93 placentas sent for histology 89% showed an abnormality. Commonly occurring placental abnormalities included: Maternal vascular under perfusion syndrome, chorioamnionitis, reteroplacental haemorrhage and distal villous immaturity or hypoplasia.
Conclusion Review of stillbirth data is essential to maintaining high standards in all maternity units. Investigations such as TORCH should be used selectively. Placental histology provides the most information for cause and planning in future pregnancies.
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