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The investigation of intrauterine death
Published online by Cambridge University Press: 10 October 2008
Extract
The detection of an intrauterine fetal death or the delivery of a stillborn infant often initiates a futile and haphazard series of investigations set against a background of parental anxiety and clinical discomfort. The changes of successful diagnosis of the cause of intrauterine or intrapartum death are better served by the adoption of a prompt and co-ordinated approach to laboratory and other investigations. The purpose of this review is to examine the ways in which the laboratory can aid in the management of fetal death. Some of the more common causes of fetal death will be outlined, with particular emphasis on the lupus anticoagulant, fetomaternal macrotransfusion and specific infections such as Listeria and parvovirus, as these are all attracting current interest and debate. The problem of the macerated stillbirth is given some prominence in order to put to rest the notion that examination of the fetus in the presence of autolysis is worthless. None of the details are comprehensive but key references to reviews have been included in order to help the perinatologist on the spot.
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