The object of our study is to reflect on our experience and to examine the findings of fetal biopsy specimens and postmortem examinations in cases referred for clinically unexpected fetal death in utero (FDIU). Clinically unexpected FDIU indicates absence of known fetal, maternal or placental risk factors, that may have caused the death.^1,2

This is a network-based cohort study of fetal biopsy specimens and postmortems carried out at Southern Health (which incorporates Monash Medical Centre, Moorabbin, Bentleigh; Monash Medical Centre, Clayton; Dandenong Hospital, Dandenong and Casey Hospital, Berwick, all in Victoria, Australia) from January 2002 to December 2005.

During this period, there were 314 fetal deaths among the 27 085 total births; 181 fetal deaths were unexpectedⁱ—these data include only fetuses of gestational age >20 weeks; unfortunately, the data for fetuses that died at <20 weeks of gestation are not recorded.

A total of 88 cases from 86 pregnancies were referred to as unexpected FDIU. Of these, 78 deaths were of singletons and 10 were of twins (two sets and six single twins). The mean (SD) gestation was 27 (6) (±17 weeks, 2SD), range 14 to 41 weeks (fig 1). The mean …