Largely unexplained but probably preventable

Paper p 657

Fetal death in labour is extremely rare. Although the total fetal death (stillbirth) rate has more than halved over the past 30 years, and is now about 5.5 per 1000 total births, the rate of intrapartum fetal death in babies above 1500 g is only 0.3 per 1000 total births. 1 2 Hypoxia is thought to be a factor in 90% of intrapartum deaths,2 and much of the reduction has been credited to continuous fetal heart rate monitoring, introduced into clinical practice about 30 years ago. Use of continuous fetal heart rate monitoring was soon found to be associated with significant falls in perinatal mortality, 3 4 and further evidence for an inverse association between the level of perinatal technology and the incidence of intrapartum fetal death came from the 1980 American national fetal mortality survey.5 Interestingly, the Dublin randomised controlled trial of fetal heart rate monitoring in …