Cause Of Fetal Death Research Articles

Factor Analysis of Age and Gravidity with Prolonged Parturition in the Obstetrics Room of the District Hospital, Viqueque City, Timor Leste

Background: Prolonged or obstructed labor accounts for 8% of the causes of maternal mortality globally and is also the cause of fetal death. One of the causes of prolonged labor is maternal age and gravidity. The purpose of this study was to analyze the factors of age and adolescence with the incidence of prolonged labor in the midwifery room of the Viqueque City Hospital, Tomor Leste.Methods: This study used an analytical research design with a cross-sectional approach. The population was all women who gave birth for a long time in the midwifery room of the Viqueque City Hospital, Timor Leste, which could be 30 people. The sampling technique used accidental sampling. The research instrument used a questionnaire and observation sheet. The data analysis used Chi Square statistical test.Results: The results showed that more than half of the respondents (66.7%) aged 20-35 years were 20 respondents and more than half (53.3%) were multigravidas as many as 16 respondents, more than half (60%) did not occur during prolonged labor, namely as many as 18 respondents. Based on the results of statistical tests using Chi Square calculations, it is not known that no one knows it is 0.002 <0.05 so it can be shown that there is a relationship between the incidence of prolonged labor.Conclusion: Women with higher parity are at higher risk of prolonged labor because the uterus has weakened the uterine wall muscles due to a previous pregnancy. The solution that needs to be done regarding the results of the research above is to enable health education about the causes and risk factors for the old party to the mother by health workers and early detection of risk factors for prolonged labor must be improved.

Modeling clinical and non-clinical determinants of intrapartum stillbirths in singletons in six public hospitals in the Greater Accra Region of Ghana: a case–control study

The Greater Accra Region (GAR) of Ghana records 2000 stillbirths annually and 40% of them occur intrapartum. An understanding of the contributing factors will facilitate the development of preventive strategies to reduce the huge numbers of intrapartum stillbirths. This study identified determinants of intrapartum stillbirths in GAR. A retrospective 1:2 unmatched case–control study was conducted in six public hospitals in the Greater Accra Region of Ghana. A multivariable binary logistic regression model was used to quantify the effect of exposures on intrapartum stillbirth. The area under the receiver operating characteristics curve and the Brier scores were used to screen potential risk factors and assess the predictive performance of the regression models. The following maternal factors increased the odds of intrapartum stillbirths: pregnancy-induced hypertension (PIH) [adjusted Odds Ratio; aOR = 3.72, 95% CI:1.71–8.10, p < 0.001]; antepartum haemorrhage (APH) [aOR = 3.28, 95% CI: 1.33–8.10, p < 0.05] and premature rupture of membranes (PROM) [aOR = 3.36, 95% CI: 1.20–9.40, p < 0.05]. Improved management of PIH, APH, PROM, and preterm delivery will reduce intrapartum stillbirth. Hospitals should improve on the quality of monitoring women during labor. Auditing of intrapartum stillbirths should be mandatory for all hospitals and Ghana Health Service should include fetal autopsy in stillbirth auditing to identify other causes of fetal deaths. Interventions to reduce intrapartum stillbirth must combine maternal, fetal and service delivery factors to make them effective.

Integrated Deep Learning and Supervised Machine Learning Model for Predictive Fetal Monitoring.

Asphyxiation associated with metabolic acidosis is one of the common causes of fetal deaths. The paper aims to develop a feature extraction and prediction algorithm capable of identifying most of the features in the SISPORTO software package and late and variable decelerations. The resulting features were used for classification based on umbilical cord pH data. The algorithms developed here were used to predict cord pH levels. The prediction system assists the obstetricians in assessing the state of the fetus better than the category methods, as only about 30% of the patients in the pathological category suffer from acidosis, while the majority of acidotic babies were in the suspect category, which is considered lower risk. By predicting the direct indicator of acidosis, umbilical cord pH, this work demonstrates a methodology, which uses fetal heart rate and uterine activity, to identify acidosis. This paper introduces a forecasting model based on deep learning to predict heart rate and uterine contractions, integrated with the classification algorithm, resulting in a robust tool for predictive fetal monitoring. The hybrid algorithm resulted in a model capable of providing future conditions of the fetus, which obstetricians can use for diagnosis and planning interventions. The ensemble classification algorithm had a test accuracy of 85% (n = 24) in predicting fetal acidosis on the features extracted from the cardiotocography data. When integrated with the classification model, the results from the prediction model (long short-term memory network) can effectively identify fetal acidosis 2 or 4 min in the future.

Reproductive Losses and Their Causes in Alpacas-A Survey-Based Study.

The profitability of alpaca breeding depends on satisfactory reproductive results. The study aimed to analyze the frequency and causes of reproduction-related problems in alpacas, in particular miscarriages, stillbirths, preterm births, twin pregnancies, and falls of crias within 12 months after birth. This analysis was carried out with the use of questionnaires completed voluntarily by 109 alpaca owners in three regions (British Isles, Continental Europe, and North America). Cases of miscarriage and stillbirths were reported from 44% and 36% of the farms, respectively. In half of the farms, the cases of falls of crias and young alpacas within 12 months after birth were reported. Preterm births were reported from almost half of the farms. A large number of alpaca owners did not identify the cause of fetal death. An important element increasing the cria survival rate of is the birth weight (the higher cria birth weight, the lower risk of perinatal complications and less necessity of bottle feeding). Crias from dams receiving mineral supplements had higher birth weight. This study indicated a relationship between fetal death and the occurrence of infectious diseases and scabies infestation in the herd. They may be potential causes of reproduction-related problems that are not discerned in time.

STUDY OF INTRAUTERINE FETAL DEATH (IUFD) A 3 YEARS RETROSPECTIVE STUDY

Introduction- Intrauterine fetal death (IUFD) is always a massive psycho-affective trauma for a woman and a couple. The investigation for the cause is essential for improving care by implementing preventative measures. Therefore, this study aimed to assess the major causes of stillbirth. The study was conduc Methods- ted at a tertiary care hospital in Kolhapur at D.Y PATIL HOSPITAL. The hospital records of intrauterine fetal death between clinical duration January 2018 to December 2020 were collected and reviewed and a total of 70 cases with pregnancies of &gt; 28weeks of gestation age, foetus weighing &gt;1000grams and singleton pregnancies were included. Detailed clinical history, examination and laboratory investigations reports were reviewed to analyse the data. In this study Demographics and clinical data were analysed using R-studio software (v.1.2.5001). Of t Result- he 70 cases, high number of women who experienced stillbirth belonged to the age group of 25-30 years (48.57%), had multigravida (70%), female baby (52.86%), term baby (58.57%). Maternal factors causing stillbirths were evident 62.86% of cases. Hypertensive disorder (25.71%), COVID- 19 positive (10%), congenital anomaly (1.43%) were the commonest maternal, placental and fetal causes of fetal death respectively. Maternal and placental causes Conclusionare more commonly resulting in an increased risk of stillbirth. Therefore, health care professionals should identify risk factors in order to prevent stillbirths.

RETROSPECTIVE STUDY OF RISK FACTORS IN PATIENTS WITH INTRAUTERINE DEATHS AFTER THE STATE OF VIABILITY REFERRED TO THE TERTIARY HEALTH FACILITY IN KODAGU

IUFD is an important indicator of maternal and perinatal Health in a given population. Fetal death from Intra partum asphyxia and Rh is immunization has almost disappeared. Toxaemia and GDM contribute significantly to fetal deaths. There is a significant decline in still birth from unexplained causes. Most frequent reported causes of fetal death earlier were prolapsed of cord, abruptioplacenta, Hydrocephalus and rupture uterus. If the causes of IUFD can be found, an effective strategy for prevention of IUFD can be materialised and complications can be prevented. Methods: Retrospective study in Tertiary Care Hospital. Results: 35 out of 38 of the patients are belong to the age group of 20-30 years. With history of reduced fetal moments, background of pre ecclampsia and anaemia contribute significantly to fetal deaths. Conclusions: to seek treating physicians with history of reduced fetal moments and aggressive treatment of PIH and anaemia can reduce the burden of IUD in this tribal belt. Illiteracy is a big burden to train and educate women to seek good antenatal care and advice. Keywords: Pre Ecclampsia Hypertention(PIH), Intra Uterine Fatal Death(IUFD), Anti Partum Haemorrhage(APH), Macerated Still Birth(MSB), Preterm Labour(PTL), Meconium Stained Liquor (MSL), Gestational Diabetes Mellitus(GDM), Pre matured rupture of Membranes(PROM), Lower Segment caesarean section(LSCS), Pre term death (PTD), Congenital Malformations(CMF).

The Importance of Post-Mortem Investigations in Stillbirths: Case Studies and a Review of the Literature.

Stillbirth has an important economic and social impact, though it remains “inexplicable” in many cases. We report the analysis of 11 cases of intrauterine fetal death carried out through a retrospective study conducted in the period between 2014 and 2017. The purpose of the study is to quantify the contribution of the autopsy and placental examination in identifying the cause of stillbirths. For each case, the medical record was analyzed with the relative maternal and partner data, the results of the external fetal and autopsy examination as well as the macroscopic and histological placental examination. The peak of stillbirth was found in a maternal age group between 30 and 39 years, below the 32nd week and above the 37th week of gestation. The results obtained from the clinical history and external fetal examination make it possible to trace the cause of death in only 18.2% of cases. By adding to these data, the results of the fetal autopsy and the placental examination, it is possible to establish the cause of death in 90.9% of cases. The most frequent abnormalities found in the placenta and cord were short or hypercoiled cord, umbilical cord vascular thrombosis, turns around the neck or stretching of the funiculus, placental infarction and placental insufficiency; also, amniotic fluid abnormalities, such as suspected oligohydramnios and chorioamniositi, were found. The accurate analysis of post-mortem placental and fetal examination is essential to reduce the number of unresponsive intrauterine fetal deaths. Determining the cause of fetal death must help clinicians and parents in better management and care in future pregnancies.

Evaluation of Congenital and Chromosomal Anomalies Mortality in Turkey by Joinpoint Regression Analysis

Congenital anomalies (CAs) represents one of the main cause of fetal death, infant mortality and morbidity, and long-term disability. This study aims that it was to analyze the mortality trends of Congenital and Chromosomal Anomalies (CCAs) mortality in Turkey. This population-based observational study covers nine years in Turkey. CCAs mortality data was reported from the Turkish Statistical Institute death database by gender and age. Age-standardized mortality rates per 100,000 population were calculated by direct standardization using the WHO Reference Population. Average annual percent change (AAPC), annual percent change (APC), and 95% confidence interval (CI) were computed using the joinpoint regression analysis. Joinpoint Regression analysis results showed a significant trend for overall CCA-type mortality over the entire observation period (AAPC=3.9%, 95% CI:1.4 to 6.4). A significant increase in the mortality rate of nervous system (in male: APC:7.6%, 95% CI: 2.2 to 13.4; in female: APC:6.6%, 95% CI:2.6 to 10.7) and circulatory system (in male: APC:4.6%, 95% CI:1.5 to 7.8; in female: APC:3.4%, 95% CI:0.8 to 6.1) were observed in both gender during the study period (p&lt;0.001). Congenital anomalies in Turkey are a major cause of fetal and neonatal death, however, most of the anomalies can be preventable or treatable.

PURPOSe study: understanding the burden of stillbirths in south Asia

PURPOSe study: understanding the burden of stillbirths in south Asia

Fetal deaths in Brazil: What changed in the last decade and what can we learn from the current situation?

To determine fetal death rates (FDRs) according to maternal characteristics in Brazil. A serial cross-sectional analysis was conducted based on vital statistics of the Brazilian population from 2007 to 2019. FDRs were estimated according to maternal and pregnancy characteristics. Annual percent change (APC) of FDR was assessed by joinpoint regression model. Causes of death were compared between the ante-/intrapartum periods. A significant reduction in FDR occurred in Brazil during 2007-2019 (11.1 and 10.43 in 2007 and 2019, respectively; APC -0.44). Only the northern region showed an increase in FDR. In 2019, the northeast and southeast had the highest and lowest FDRs, respectively (11.4 and 7.8/1000 live births). In adolescents, FDR increased from 2007 to 2016 (APC 1.75). In 2019, missing information was significantly high for maternal skin color (99.7%), schooling (17.0%), and age (7.0%) in fetal death registries. The most common causes of fetal death in the ante-/intrapartum periods were fetus and newborn affected by maternal conditions. A reduction in FDR has been achieved in Brazil over the last decade. However, there is an unmet need for decreasing social and regional disparities. A better system to attribute causes of death is needed to identifying priorities in maternal-fetal health care.

Congenital heart defects in the fetus and embryological classification: Cladistics and phylogeny

Congenital heart defects (CHD) are a common cause of fetal death and termination of pregnancy for fetal anomaly (TPFA). No series with sufficient cohort, based on description of the anatomic phenotype of CHD discovered in fetal period, have been published until now. To phenotype all the fetal cardiac specimens of the M3 C collection, which counts more than 1500 hearts. A complete morphological examination of each specimen according to segmental analysis was performed by two observers (MH, LH). We determined the main CHD according to the 11 categories and 23 subcategories of the clinical and anatomical classification of CHD and we coded the associated lesions with IPCCC codes. These codes were recorded in a database including photographs for each heart. To date, we have analyzed 758 cardiac specimens. Among them, 77 were normal (10.2%). The most frequent groups of CHD were: anomalies of the ventricular outflow tracts (VOT, 34%), functionally univentricular hearts (FUV, 24%) and anomalies of atrioventricular junctions and valves (AAVJV, 15%). As an example of a phylogenetic analysis starting from a specific anomaly, a right aortic arch was most frequent in double outlet right ventricle with subaortic ventricular septal defect (VSD) (39%), tetralogy of Fallot group (24%) and outlet VSD (9%). It was almost absent in other anomalies of VOT and other CHD ( Fig. 1 ). These first results confirm the predominance of the anomalies of the VOT. The high rate of FUV and AAVJV underlines the selection bias related to the high number of TPFA for severe CHD or chromosomal abnormality. This anatomical phenotyping of the collection should allow us to identify rare associations of malformations and could change our current way of grouping some phenotypes together. This could help us, by integrating current embryological knowledge, to elaborate a cladistics analysis of CHD, starting from one part of the phenotype.

Congenital heart defects in the foetus and embryological classification: Cladistic et phylogeny

Congenital heart defects (CHD) are a common cause of fetal death and termination of pregnancy for fetal anomaly (TPFA). No series with sufficient cohort, based on description of the anatomic phenotype of CHD discovered in fetal period, have been published until now. The aim of our study is to phenotype all the fetal cardiac specimens of the M3 C collection, which counts more than one thousand hearts. A complete morphological examination of each specimen according to segmental analysis was performed by two observers (MH,LH). We determined the main CHD according to the 11 categories et 23 sub-categories of the clinical and anatomical classification of CHD [2] and we coded the associated lesions with IPCCC codes according to the ICD-11 CHD classification [1] . These codes were recorded in a database created for that purpose including photographs for each heart. To date, we have analyzed 758 cardiac specimens. Among them, 77 were normal hearts (10,2%). The most frequent main groups of CHD were: anomalies of the ventricular outflow tracts (VOT) (231, 34%), functionally univentricular hearts (FUV) (165, 24%) and anomalies of atrioventricular junctions and valves (AVJV) (106, 15%). The most frequent associated lesions were: anomalies of the valves (all valve type; 409, 60%), ventricular hypoplasia (265, 39%), ventricular septal defects (233, 34%), interatrial communications (204, 30%), anomalies of the arterial duct (152, 22%). These first Results confirm the predominance of the anomalies of the VOT. The high rate of FUV and anomalies of AVJV underlines the selection bias related to the high number of TPFA for severe CHD or chromosomal abnormality. This anatomical phenotyping of the collection should allow us to identify rare associations of malformations and could change our current way of grouping some phenotypes together. This could help us, by integrating current embryological knowledge, to elaborate a cladistic analysis of CHD.

Maternal and fetal characteristics and causes of stillbirth in a tertiary care hospital of Nepal: secondary analysis of registry-based surveillance data

ObjectivesStillbirth is one of the vital indicators of quality care. This study aimed to determine maternal-fetal characteristics and causes of stillbirth in Nepal.DesignSecondary analysis of single-centred registry-based surveillance data.SettingThe study...

Intrauterine fetal death: Five years’ experience in a secondary care hospital.

Objectives: The objectives of this study were to estimate the prevalence, preoperative, and operative risk factors associated with the higher risk of SSI in gynecologic cancer patients undergoing surgery in a tertiary care facility in a developing country. Study Design: Retrospective Study. Setting: Obstetrics and Gynecology Department, Agha Khan Hospital for Women Garden Karachi, Pakistan. Period: Jan 2012 to Dec 2016. Material &amp; Methods: Retrospective review of medical records of patients over a period of five years from Jan 2012 to Dec 2016 was done. Results: The study consisted of 56 cases of intrauterine fetal demise out of 4813 number of deliveries which occurred during the study duration. Overall estimated rate of intrauterine fetal demise was 11.6 %( 56/4813). Approximately 33.9% of cases did not have a clear cause of fetal death identified and hence were un-explained. In 56 cases, 28.6% had some form of congenital abnormality identified on ultrasound, 7.1% (n=4) had anemia, 23.2% (n=13) IUGR, 5.4% (n=3) placental abruption and 1.8% (n=1) of gestational diabetes and around 83.9% (n=47) had normal vaginal delivery and 8 were delivered by LSCS and only 1 patient had instrumental delivery. Fetal characteristics identified 50% (n=28) were males and 50% (n=28) were females. 4 fetuses were born with tight cord around their neck 58.1% were macerated stillbirths (n=25) while 32.6% were fresh stillbirth. Conclusion: Antepartum intrauterine fetal death or stillbirths in the third trimester, affect the entire family. We conclude from our study that quality antenatal care with health education and timely interventions can reduce the number of intrauterine fetal deaths thus reducing the psychological sequelae.

Novel Morbillivirus as Putative Cause of Fetal Death and Encephalitis among Swine.

Morbilliviruses are highly contagious pathogens. The Morbillivirus genus includes measles virus, canine distemper virus (CDV), phocine distemper virus (PDV), peste des petits ruminants virus, rinderpest virus, and feline morbillivirus. We detected a novel porcine morbillivirus (PoMV) as a putative cause of fetal death, encephalitis, and placentitis among swine by using histopathology, metagenomic sequencing, and in situ hybridization. Phylogenetic analyses showed PoMV is most closely related to CDV (62.9% nt identities) and PDV (62.8% nt identities). We observed intranuclear inclusions in neurons and glial cells of swine fetuses with encephalitis. Cellular tropism is similar to other morbilliviruses, and PoMV viral RNA was detected in neurons, respiratory epithelium, and lymphocytes. This study provides fundamental knowledge concerning the pathology, genome composition, transmission, and cellular tropism of a novel pathogen within the genus Morbillivirus and opens the door to a new, applicable disease model to drive research forward.

Fetal death from ascending bacterial infection. Diagnostic method, a narrative review. Why is the method that includes placental study, evaluation of clinical and laboratory data efficient in identifying ascending bacterial infection as the cause of fetal death?

This narrative review includes published studies of stillbirth classification methods and their efficiency in identifying ascending bacterial infection (ABI), as a cause of fetal death (FD), by searching PubMed, Cochrane, Embase, ScienceDirect, Wiley Online Library, Scielo. Many children die before birth around the world and it has not been possible to reduce FD because the methods used have not been adequate and because ABI, the most frequent cause of FD in a public hospital in Chile, is not diagnosed. Systems using clinical, laboratory and placental study data, INCODE, CORM, are more efficient in identifying ABI as the origin of FD. Specific markers of infection/placental inflammation, histologic chorioamnionitis/acute funitis have been shown to be more efficient in diagnosing ABI than fetal autopsy, that amniotic fluid culture is more efficient than placental culture for detect microbial invasion of the amniotic cavity and that the cord blood sample is efficient for the etiological diagnosis of the infection. The knowledge of the ABI as the initial cause of FD helps to develop guidelines and norms for preventing FD due to this condition.

Congenital heart defects in the foetus and embryological classification: Cladistic et phylogeny

Congenital heart defects (CHD) are a common cause of fetal death and termination of pregnancy for fetal anomaly (TPFA). No series with sufficient cohort, based on description of the anatomic phenotype of CHD discovered in fetal period, have been published until now. The aim of our study is to phenotype all the fetal cardiac specimens of the M3C collection, which counts more than one thousand hearts. A complete morphological examination of each specimen according to segmental analysis was performed by two observers (MH, LH). We determined the main CHD according to the 11 categories and 23 sub-categories of the clinical and anatomical classification of CHD and we coded the associated lesions with IPCCC codes according to the ICD-11 CHD classification. These codes were recorded in a database created for that purpose including photographs of each heart. To date, we have analyzed 697 cardiac specimens. Among them, 64 were normal hearts (9%). The most frequent main groups of CHD were: anomalies of the ventricular outflow tracts (VOT) (197, 28%), functionally univentricular hearts (FUV) (164, 24%), anomalies of atrioventricular junction and valves (AVJV) (95, 14%). The most frequent associated lesions were: anomalies of the valves (all valve type; 442, 63%), ventricular septal defects (241, 35%), interatrial communications (198, 28%), ventricular hypoplasia (172, 25%), anomalies of the arterial duct (152, 22%). These first results confirm the predominance of the anomalies of the VOT. The high rate of FUV and anomalies of AVJV underlines the selection bias related to the high number of TPFA for severe CHD or chromosomal abnormality. This anatomical phenotyping of the collection should allow us to identify rare associations of malformations and could change our current way of grouping some phenotypes together. This could help us, by integrating current embryological knowledge, to elaborate a cladistic analysis of CHD.

Umbilical Cord Teratoma: A Rare Case Report

The state of the stroma, blood vessels and the anatomical features of the umbilical cord are of direct diagnostic value, and various pathological changes can become the primary cause of fetal death. The frequency of umbilical cord tumors is not reliably known due to a very rare incidence: in the available literature there were reported about 19 cases.The aim of the study was to clinically and pathohistologically analyze a case of umbilical cord teratoma and to give an analytical review of recently reported cases.The material was obtained from a healthy 35-year-old woman with a third pregnancy. Combined ultrasound screening at the 20th week of pregnancy revealed a solid structure with cystic inclusions along the periphery on the umbilical cord. In the solid component, hyperechoic inclusions giving acoustic shadows were visualized; in the color Doppler imaging mode the neoplasm was avascular. A dead premature baby girl was born at 35th week. The cause of intrauterine fetal death was mechanical compression of the vessels of the umbilical cord by teratoma. Microscopic examination of the umbilical cord neoplasm in the area of the solid component demonstrated a pronounced development of the sebaceous glands, adipose tissue, myelinic nerve fibers, hair follicles; in the cystic component – epidermoid cysts. This evidenced about organismoid mature teratomas. Due to their rare incidence umbilical teratomas should be reported to better understand their pathomorphosis and impact on infant morbidity and mortality. Given the increased risk of concomitant malformations, the detection of an umbilical teratoma should be accompanied by a detailed and comprehensive examination of the newborn for additional pathologies.

Causal analysis of fetal death in high-risk pregnancies.

To determine the causes of fetal death among the stillbirths using two classification systems from 22weeks of gestation in a period of three years in high-risk pregnancies. This is a retrospective observational study. The National Institute of Perinatal Health in Mexico City is a Level 3 care referral center attending high-risk pregnancies from throughout the country. The population consisted of patients with fetal death during a three-year period. Between January 2016 and December 2018, all stillbirths were examined in the Pathology Department by a pathologist and a medical geneticist. Stillbirth was defined as a fetal death occurring after 22weeks of gestation. Main outcome measures: Causal analysis of fetal death using the International Statistical Classification of Disease and Related Health Problems-Perinatal Mortality (ICD-PM) and initial causes of fetal death (INCODE) classification systems. A total of 297 stillborn neonates were studied. The distribution of gestational age in antepartum stillbirths (55.2%) showed a bimodal curve, 36% occurred between 24 and 27weeks and 32% between 32 and 36weeks. In comparison, the majority (86%) of intrapartum deaths (44.8%) were less than 28weeks of gestation. Of the 273 women enrolled, 93 (34%) consented to a complete fetal autopsy. The INCODE system showed a present cause in 42%, a possible cause in 54% and a probable cause in 93% of patients. The principal causes of antepartum death were fetal abnormalities and pathologic placental conditions and the principal causes of intrapartum death were complications of pregnancy which caused a premature labor and infections.

Avoidability of fetal deaths: reflections on the Brazilian List of Avoidable Causes of Deaths through interventions by the Brazilian Unified National Health System

Although the Brazilian List of Avoidable Causes of Deaths (LBE in Portuguese), in its version for children under 5 years of age (LBE < 5), does not include stillbirths, some studies have used the list with or without adaptations. We present a proposal for adaptation of the LBE for stillbirths (LBE-OF in Portuguese) and the results of its application to stillbirths in the State of Rio de Janeiro, Brazil, in 2018, compared to the results with LBE < 5. We reviewed the categories from the 10th revision of the International Classification of Diseases (ICD-10) in the LBE < 5 and reassigned them in the avoidability groups, according to time of death in relation to delivery and the causes consistent with stillbirths. Conditions that did not elucidate the determinants of death were allocated as ill-defined causes. Stillbirths in the State of Rio de Janeiro, selected from the databases of the Mortality Information System (SIM in Portuguese), were classified according to LBE-OF and LBE < 5. When classifying the 2,585 stillbirths that occurred in the State of Rio de Janeiro in 2018, we found that according to LBE < 5, there were predominantly causes "reducible by adequate care in labor and delivery" (42.9%), while according to LBE-OF, the most frequent causes were "reducible by adequate care for during pregnancy" (43.6%). Ill-defined causes ranked second according to the LBE-OF (35.4%) and third according to LBE < 5. Some 30% of stillbirths changed groups and subgroups of avoidability, showing greater consistency with the profile of obstetric care. Although identifying a higher percentage of ill-defined causes, the LBE-OF is more consistent with the pathophysiology of fetal deaths. The inclusion of stillbirths in the SIM would be a positive step in monitoring and upgrading the investigation of causes of fetal death.