Dr. Chapa’s Clinical Pearls. New SMFM Stillbirth Checklist Update (July 2025)
Jul 5, 2025
Stillbirth is profoundly tragic, affecting 1 in 160 deliveries in the U.S. A new checklist from the Society for Maternal-Fetal Medicine aims to enhance care for pregnancies impacted by stillbirth. The importance of history-taking, fetal autopsy, and advanced genetic testing are crucial in understanding causes. The updated checklist highlights detailed evaluations during delivery, focusing on neonate and placenta assessments. Additionally, evaluating placental health and facilitating timely decision-making are key in managing these sensitive cases.
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Unexplained Stillbirths and Genetics
- New SMFM checklist for stillbirth includes evaluation steps previously overlooked, like genetic testing for cardiac events.
- Sudden fetal cardiac events may explain many unexplained stillbirths, shifting medical understanding.
Thorough History and Autopsy Essential
- Perform thorough history including environmental exposures, medications, illnesses, trauma, family history.
- Always request fetal autopsy as it can reveal causes not visible on imaging or basic testing.
Advanced Genetic Testing Recommended
- Use microarray analysis over traditional karyotype for genetic testing in stillbirth.
- Include whole exon sequencing targeting long QT and channelopathy genes like CALM and KCN for comprehensive evaluation.