CC BY-NC-ND 4.0 · J Lab Physicians 2023; 15(04): 475-487
DOI: 10.1055/s-0043-1764485
Review Article

Stillbirth Investigations: An Iconographic and Concise Diagnostic Workup in Perinatal Pathology

1   Department of Anatomic Pathology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
Deborah Spencer
2   Department of Pathology, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina, United States
Taher Al-Jishi
3   Department of Obstetrics and Gynecology University of Ottawa, Ottawa, Ontario, Canada
› Author Affiliations


Introduction Stillbirth is a dramatic event for the parents, health care team, and anyone close to the expectant parents. Multidisciplinary team (MDT) meetings are essential to improve communication in health care. We review the most frequent findings discussed at MDT meetings.

Methods A PubMed search was conducted through December 2021 since the inception (1965) using clinical queries with the key terms “stillbirth” AND “investigation” AND “pathology” AND “human.” The search strategy included reviews, meta-analyses, randomized controlled trials, clinical trials, and observational studies. This systematic review is based on, but not limited to, the search results. It is the experience of more than 30 years of pediatrics, obstetrics, and pathology staff.

Results Two hundred and six articles were screened and complemented through the perusal of congressional activities and personal communications. Pathological findings following perinatal death can be divided into macroscopic, histologic, and placental findings. The placenta is crucial in fetal medicine and is key in determining the cause of stillbirth in a substantial number of events. Perinatal lung disease is essential to evaluate the response of newborns to extrauterine life and address newborns' outcomes appropriately.

Conclusions Stillbirth remains one of the less explored areas of medicine, and we can determine the cause in a limited number of cases. Nevertheless, placental pathology is critical in the etiology discovery pathway. Accurate investigations and discussion of photography-supported findings are vital in promoting communication at MDT meetings.

Author Contribution

C.M.S. was responsible for project development, data collection, and manuscript writing. D.S. and T.A.J. were responsible for data collection and manuscript writing. All the authors reviewed the manuscript and approved it before submission.

Publication History

Received: 24 August 2022

Accepted: 23 January 2023

Article published online:
18 April 2023

© 2023. The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

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