Perinatal mortality has decreased over the past 20 years, and the availability of prenatal care is now recognized as a factor in this improvement. Lupus anticoagulant and anticardiolipin antibodies do not appear to be useful screening tools for perinatal loss. Intrauterine growth retardation remains the second leading known cause of fetal death. Additionally, intrauterine growth retardation causes impaired development lasting into childhood, and the most vulnerable group are those born before 33 weeks' gestation. Newer approaches to the diagnosis and establishment of prognosis for fetuses with intrauterine growth retardation are also reviewed.