Understanding the clinical utility of stillbirth investigations: a scoping review
Abstract Background Investigating the causes of stillbirth is crucial for both parents and healthcare providers as it helps explain why the baby died, guides clinical care in future pregnancies, and aids in developing strategies to prevent stillbirth. The usefulness or utility of investigations for...
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BMC
2025-02-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | https://doi.org/10.1186/s12884-025-07345-1 |
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| author | Tania Marsden Heidi Shukralla T. Yee Khong Jane E. Dahlstrom Vicki Flenady Jessica Sexton |
| author_facet | Tania Marsden Heidi Shukralla T. Yee Khong Jane E. Dahlstrom Vicki Flenady Jessica Sexton |
| author_sort | Tania Marsden |
| collection | DOAJ |
| description | Abstract Background Investigating the causes of stillbirth is crucial for both parents and healthcare providers as it helps explain why the baby died, guides clinical care in future pregnancies, and aids in developing strategies to prevent stillbirth. The usefulness or utility of investigations for stillbirth is poorly defined and unclear. As a result, protocols for investigating the causes of stillbirth are currently based on clinical consensus and fail to prioritise investigative approaches that are most effective at determining a cause of death. Objectives The objectives of this scoping review were to identify the available evidence, key characteristics, and knowledge gaps regarding the utility of stillbirth investigations. Search strategy An a priori protocol was implemented and included a systematic search in MEDLINE, CINAHL, EMBASE, Scopus, and Cochrane from inception until 28 May 2024. Selection criteria Studies examining stillbirth investigations, yield, and value were included. Data collection and analysis Data were collected using a purpose-built data extraction tool and an analysis was undertaken. Results 57 potentially eligible studies were identified, and 34 studies (with 11,410 stillbirths) were included. Three studies examined clinical utility using a comprehensive testing protocol. Definition of utility or value of investigations varied across the studies, classification system for cause of death and investigation protocols varied. Placental pathology was reported as the most useful investigation in 65%–96% of cases, identified a cause of death in 61–71% of cases and impacting the medical management in 36% of cases (13 studies, 5,169 stillbirths). Autopsy can identify the cause of death in 36–77% of cases and provided new information in 17–26% of cases (17 studies, 4,336 stillbirths). Genetic analysis was useful in 29% of cases (seven studies, 1,886 stillbirths). One study (512 stillbirths) examined the value of investigation by presenting clinical scenario. Conclusions This review indicates that Investigation protocols for stillbirth should include placental pathology, autopsy, and genetic testing. Future studies should address the value of tests by presenting clinical scenarios, use of a consistent definition of stillbirth, classification system and measurement of investigation value. |
| format | Article |
| id | doaj-art-250941d97d1b414b94441ef7ea415d83 |
| institution | DOAJ |
| issn | 1471-2393 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj-art-250941d97d1b414b94441ef7ea415d832025-08-20T03:03:46ZengBMCBMC Pregnancy and Childbirth1471-23932025-02-0125111710.1186/s12884-025-07345-1Understanding the clinical utility of stillbirth investigations: a scoping reviewTania Marsden0Heidi Shukralla1T. Yee Khong2Jane E. Dahlstrom3Vicki Flenady4Jessica Sexton5NHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute – University of QueenslandLinear Clinical ResearchSA Pathology, Women’s and Children’s HospitalACT Pathology, Canberra Health Services and School of Medicine and Psychology, ANU College of Health and MedicineNHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute – University of QueenslandNHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute – University of QueenslandAbstract Background Investigating the causes of stillbirth is crucial for both parents and healthcare providers as it helps explain why the baby died, guides clinical care in future pregnancies, and aids in developing strategies to prevent stillbirth. The usefulness or utility of investigations for stillbirth is poorly defined and unclear. As a result, protocols for investigating the causes of stillbirth are currently based on clinical consensus and fail to prioritise investigative approaches that are most effective at determining a cause of death. Objectives The objectives of this scoping review were to identify the available evidence, key characteristics, and knowledge gaps regarding the utility of stillbirth investigations. Search strategy An a priori protocol was implemented and included a systematic search in MEDLINE, CINAHL, EMBASE, Scopus, and Cochrane from inception until 28 May 2024. Selection criteria Studies examining stillbirth investigations, yield, and value were included. Data collection and analysis Data were collected using a purpose-built data extraction tool and an analysis was undertaken. Results 57 potentially eligible studies were identified, and 34 studies (with 11,410 stillbirths) were included. Three studies examined clinical utility using a comprehensive testing protocol. Definition of utility or value of investigations varied across the studies, classification system for cause of death and investigation protocols varied. Placental pathology was reported as the most useful investigation in 65%–96% of cases, identified a cause of death in 61–71% of cases and impacting the medical management in 36% of cases (13 studies, 5,169 stillbirths). Autopsy can identify the cause of death in 36–77% of cases and provided new information in 17–26% of cases (17 studies, 4,336 stillbirths). Genetic analysis was useful in 29% of cases (seven studies, 1,886 stillbirths). One study (512 stillbirths) examined the value of investigation by presenting clinical scenario. Conclusions This review indicates that Investigation protocols for stillbirth should include placental pathology, autopsy, and genetic testing. Future studies should address the value of tests by presenting clinical scenarios, use of a consistent definition of stillbirth, classification system and measurement of investigation value.https://doi.org/10.1186/s12884-025-07345-1StillbirthsYieldValueQualityInvestigationTests |
| spellingShingle | Tania Marsden Heidi Shukralla T. Yee Khong Jane E. Dahlstrom Vicki Flenady Jessica Sexton Understanding the clinical utility of stillbirth investigations: a scoping review BMC Pregnancy and Childbirth Stillbirths Yield Value Quality Investigation Tests |
| title | Understanding the clinical utility of stillbirth investigations: a scoping review |
| title_full | Understanding the clinical utility of stillbirth investigations: a scoping review |
| title_fullStr | Understanding the clinical utility of stillbirth investigations: a scoping review |
| title_full_unstemmed | Understanding the clinical utility of stillbirth investigations: a scoping review |
| title_short | Understanding the clinical utility of stillbirth investigations: a scoping review |
| title_sort | understanding the clinical utility of stillbirth investigations a scoping review |
| topic | Stillbirths Yield Value Quality Investigation Tests |
| url | https://doi.org/10.1186/s12884-025-07345-1 |
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