Background:

the number of stillbirth cases has been reduced in the developed countries due to improvements in pregnancy care. It is important to know the causes in order to prevent fetal death. Early identification of risk factors for stillbirth may reduce the number of cases.

The objective:

of this paper is to identify the underlying pathologies of the cases that underwent an autopsy at Pereira Rossell Hospital in Montevideo, in order to contribute to the reduction of fetal mortality.

Methods:

this is a retrospective and descriptive study of autopsy and placental examinations, performed at the Pediatric Pathology Laboratory of Pereira Rossell Hospital in Montevideo. A standard protocol was applied. Data were analyzed overall.

Results:

congenital malformations were identified in 17.7% of cases; congenital infection in the fetus was found in 20.4%. Infection altogether (in the autopsy and/or the placenta) was identified in 383 cases (45.3%). Syphilis was diagnosed in 10.5% of the stillborn. Fetal evidence of asphyxia accounted for 11.5% and miscellaneous pathologies 3.5%. In 50.4% of cases the autopsy did not reveal alterations, but 90% of corresponding placentas had lesions that could have caused the death of the fetus. Maternal underperfusion or malperfusion was found in 14.2% of the placentas. Chorioamnionitis was seen in 30.5%. A retroplacental hematoma was seen in 26.6%. Stillbirth was of unexplained in 4.9% of the cases.

Conclusion:

a high percent of the cases studied had a preventable pathology. Many recurrent lesions were identified as well as cases that required additional medication to the mother. The results of the pathology examination should be considered in order to reduce the stillbirth rate.

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