Stillbirth and associated factors in a developing country

INTRODUCTION: Stillbirth is one of the most adverse outcomes for both families and obstetricians. In this study, we aimed to evaluate the incidence, causes, risk factors, delivery methods, and placental pathologies associated with stillbirth at our obstetric center.
METHODS: This retrospective descriptive study was conducted in the obstetrics clinic of a tertiary hospital. Stillbirths occurring between February 2018 and October 2023 were included in the study. A total of 109 stillbirths among 27,034 live births were included. The obstetric, perinatal, and neonatal outcomes of the women included in the study were examined.
RESULTS: The stillbirth rate at our hospital was 4.03 per 1000 births. In this study, 49 (45%) women were admitted to the hospital with reduced fetal movement. Fetal growth restriction, observed in 21 (19.3%) cases, was determined to be the leading cause of stillbirth. The rate of unexplained/unclassifiable stillbirth was 18 (16.5%). Among the placentas of stillborn fetuses examined, the most frequently detected histopathological findings were perivillous/intervillous fibrin accumulation in 52 (74.3%) cases, calcification in 33 (47.1%), intraparenchymal hemorrhage/hematoma in 31 (44.3%), decidual inflammation in 31 (44.3%), increased syncytial knots in 26 (37.1%), and necrotic decidua in 23 (32.9%).
DISCUSSION AND CONCLUSION: Stillbirth rates are among the main indicators of the quality of obstetric care. Stillbirth causes emotional devastation and grief among parents. To reduce stillbirth rates, specific risk factors in women should be identified, and strategies to prevent pregnancy complications should be established during antenatal visits. Pathological examination of the placenta should be performed as part of the evaluation of stillbirths.

Keywords: Etiology, fetal death, fetal demise, placental pathology, pregnancy.