Original ArticlesDeterminants of unexplained antepartum fetal deaths
Section snippets
Methods
The study cohort comprised infants delivered at the Royal Victoria Hospital in Montreal between 1961 and 1996 excluding those delivered in 1975–1977, for whom computerized data were not available. This teaching hospital serves a socioeconomically and ethnically diverse population. During those years, information on all deliveries was entered into a computerized data bank2 maintained by one of the authors (RHU). Of the 105,201 total births of 500 g or more, there were 196 unexplained fetal
Results
During the years 1961–1974 and 1978–1996, there were 721 fetal deaths among the 105,201 total births of 500 g or more (7.1 per 1000). Of these fetal deaths, 196 (27.2% or 1.9 per 1000 total births) occurred antepartum and could not be explained. Although the rate of fetal deaths, including unexplained fetal deaths, has decreased over the four decades, the proportion that is unexplained has remained fairly constant, between 20.0% and 30.2%. The rate of unexplained fetal deaths per 1000 total
Discussion
The sudden death of a fetus in utero for no apparent reason is a tragedy, particularly when it occurs shortly before the expected delivery date. At our institution, unexplained antepartum fetal deaths currently comprise 25% of all fetal deaths; this proportion has remained fairly constant despite advances in antenatal diagnostic instruments. However, these deaths have received little attention in the literature.3, 4, 5
Yudkin et al3 reported an institutional analysis of 63 unexplained
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