Invasive post-mortem examination of stillborn babies is yielding little information about the cause of the problem, according to a major new examination.
Most cases remain unexplained while such explanation as there is comes from clinical review and examination of the placenta, according to the research at Great Ormond Street Hospital, London, UK.
The findings come from an analysis of more than 1,000 cases reported in a series of articles in Ultrasound in Obstetrics and Gynaecology.
The research found that clinical review pin-pointed the cause of death in 20% of deaths and placental examination provided a cause in another 20% of cases.
The researchers also say the connection between the size of the baby and stillbirth may have been exaggerated – as there was evidence of babies losing weight after death.
Researcher Professor Neil Sebire, a paediatric pathologist, said: "The problem is that using current methods, even including full autopsy, we are still often not able to find out why the baby has died.
"It’s therefore vitally important that we advance better ways of properly investigating these cases by developing new, more refined techniques. This will ensure we can support families in the best possible way.”
He added: "This research highlights that, in the case of stillbirths, analysing information such as the clinical circumstances and examination of the placenta, without the use of invasive techniques, allows us to get almost as much information."
Journal editor Professor Basky Thilaganathan said: "This finding questions the fundamental rationale and potential effectiveness of current health policy that is solely focused on the detection and elective birth of small foetuses to reduce the risk of stillbirth.”
Clea Harmer, from the charity Sands, which backed the research, said: "This study reveals how much we can expect to learn from the way post mortems are done today and highlights just how many gaps there are in our knowledge.
"These gaps won’t close without continued and expanded funding for research, and access to good-quality pathology services for all parents when their baby dies."
Ultrasound in Obstetrics and Gynaecology 26 October 2016 [abstract]
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