Pregnancy loss, stillbirth, and neonatal death. A guide for the pediatrician.

The complete clinical evaluation of pregnancy loss, stillborn infants, and neonatal deaths can result in the anticipation of an accurate diagnosis in a high percentage of cases. Appropriate focused fetal studies may include a clinical examination, fetal karyotype, photographs, skeletal radiographs, fetal autopsy, examination of the placenta and cord, and occasionally cultures or DNA studies. Knowledge of specific causes of fetal death and their clinical presentation can greatly assist the pediatrician in choosing the most appropriate studies. Many of the disorders leading to fetal death carry significant genetic recurrence risks, making an accurate diagnosis even more crucial. As our understanding of the causes of pregnancy loss improves, so does our ability to provide families with accurate counseling regarding their reproductive options.