Stillbirths: An Underestimated and Neglected Reality

About 2.6 million stillbirths annually are estimated to occur worldwide, mainly in developing countries, although much of the data is incomplete. The aim of the present study was to analyze cases of stillbirth examined in an Institute of Forensic Medicine of the Federal District (IML-DF), Brazil. A total of 38 cases were analyzed, mostly male, with a mean gestational age of 32.9 ± 6.38 weeks. Maternal causes predominated, with hypertensive disorders during pregnancy and trauma as the leading causes; placental causes followed, the most frequent being premature detachment of the placenta. Fetal causes occurred in three cases (one of the case is cardiac malformation and two are kidney disease). In nine cases, the cause of stillbirth could not be determined. The authors call attention to the importance of stillbirth rate, which is considered one of the best indicators of quality of life in a population; to the lack of reliable data for assessing such rate; and to the main factors associated with fetal death and the measures that could be taken to prevent such death. The occurrence of a stillbirth affects the mother, the family, the professionals responsible, the community, and the society. It is a heavy burden for the affected families, and psychological symptoms often persist long after the death of the babies. The authors believe that stigmas and taboos exacerbate the trauma for the families and that fatalism undermines the prevention of stillbirths, which in most cases is possible with the improvement of health services.