Rationalizing definitions and procedures for optimizing clinical care and public health in fetal death and stillbirth

Obstetrics and Gynecology
K S JosephLily Lee

Abstract

Despite the recent focus on stillbirth, there remains a profound need to address problems associated with the definitions and procedures related to fetal death and stillbirth. The current definition of fetal death, first proposed in 1950, needs to be updated to distinguish between the timing of fetal death (which has etiologic and prognostic significance) and the timing of stillbirth (ie, the delivery of the dead fetus). Stillbirth registration procedures, modeled after live birth registration and not death registration, also need to be modernized because they can be an unnecessary burden on some grieving families. The problems associated with fetal death definitions and stillbirth-associated procedures are highlighted by selective fetal reduction in multifetal pregnancy; in many countries, the fetus reduced at 10-13 weeks of gestation and delivered at term gestation requires stillbirth registration and a burial permit even if fetal remains cannot be identified. An international consensus is needed to standardize the definition of reportable fetal deaths; ideally this should be based on the timing of fetal death and should address the status of pregnancy terminations. In this article, we list propositions for initiating an inte...Continue Reading

References

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Citations

Jan 16, 2016·Paediatric and Perinatal Epidemiology·K S Joseph
Oct 19, 2016·BJOG : an International Journal of Obstetrics and Gynaecology·E R AllansonA M Gülmezoglu
Oct 26, 2016·BJOG : an International Journal of Obstetrics and Gynaecology·K S JosephK Williams
Aug 8, 2017·BJOG : an International Journal of Obstetrics and Gynaecology·K S JosephL Lee
Oct 4, 2019·BJOG : an International Journal of Obstetrics and Gynaecology·L K SmithUNKNOWN Euro-Peristat Scientific Committee
Jul 7, 2017·Current Epidemiology Reports·K S JosephSarka Lisonkova
Dec 21, 2019·Canadian Journal of Public Health = Revue Canadienne De Santé Publique·Deshayne B FellJoel G Ray
Mar 21, 2021·Canadian Journal of Public Health = Revue Canadienne De Santé Publique·K S JosephMichael S Kramer
Jul 31, 2019·Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstétrique Et Gynécologie Du Canada : JOGC·Sarah Naden SmithAdewumi Adanlawo
Dec 11, 2019·Pediatrics·Richard D Goldstein

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