Stillbirth and bereavement: guidelines for stillbirth investigation.

OBJECTIVES: To provide an investigation protocol to help health care providers determine the cause of a fetal death.

OPTIONS: Consideration has been given to protocols for the investigation of fetal death that are currently available in Canada and in other countries.

OUTCOMES: Identification of possible causes of stillbirth and their relationship to future pregnancies.

EVIDENCE: Articles related to the etiology of fetal death were identified in a search of MEDLINE (January 1993 to December 2004), the Cochrane Library, and investigation protocols from the American College of Obstetricians and Gynecologists, the Alberta Medical Association Committee on Reproductive Care, and the Centers for Disease Control and Prevention National Center for Health Statistics.

BENEFITS: To provide better advice for women regarding possible causes of fetal death and implications for future pregnancies.

RECOMMENDATION: A protocol should be used to investigate the possible cause of a fetal death. (II-B) VALIDATION: The evidence obtained was reviewed and evaluated by the Maternal-Fetal Medicine Committee and the Clinical Practice Obstetrics Committee of the Society of Obstetricians and Gynaecologists of Canada. The level of evidence and quality of there commendation made was described using the Evaluation of Evidence criteria of the Canadian Task Force on the Periodic Health Examination.