Difficulties for identification of cause of fetal death: how to solve?

PURPOSE: To identify the causes of fetal death in the studied population and to measure their contribution in identifying the cause of this outcome. To propose the use of the system Relevant Condition of Death (ReCoDe) in elucidating the causes of fetal death to minimize the number of unknown causes. METHODS: Cross-sectional study related to fetal deaths seen at a specialized academic hospital in the South of Brazil, from January 2000 to December 2009. The data were collected in the death certificates, maternal medical records and the reports of study of fetuses and attachments, and the findings were compared. Data analysis was performed using SPSS version 17.0. RESULTS: Were included 111 fetuses and their respective mothers in this study. The comparison between the diagnostic causes in the pathology and clinical evaluation showed 74 (66.7%) and 73 (65.8%), respectively. Together, they found a potential cause in 48.7% of cases, while 16.2% remained unknown. When analyzing both together with the ReCoDe system, only 9.9% of stillbirths remained as unclassified. CONCLUSIONS: The proportion of diagnoses in the cause of death among the pathological and clinical evaluation showed no significant difference. When comparing the results of the cause of death suggested by the clinic/pathology with the use of the ReCoDe system, it appears that this tool has helped to clarify the cause by reducing the amount of those that remained without a possible etiology.