WISSP - Justification of WiSSP Protocol

Justification of WiSSP Protocol

An adequate stillbirth assessment is easier by use of a specific protocol. By following the WiSSP protocol algorithm, you will be able to perform a step-by-step evaluation of a stillborn infant. With adequate assessment a specific etiology of a stillborn's death frequently can be discovered.

Recent literature has surveyed over 30 protocols for stillbirth assessments in use, most identifying a discrete cause in at least 70% of cases and at least one contributing factor in nearly 95%.

WiSSP Referral Chart

VanderWielen et al, 2010

WiSSP recommends that ALL steps be carried out in ALL stillborn infants. Commonly experts may not be available to determine which aspects of the protocol could be eliminated in a particular case, and so assessment including all steps will assure that all stillborns are appropriately evaluated. We at WiSSP have seen firsthand the importance in performing all steps, as each element in the protocol algorithm has been critical to the generation of diagnoses. An unbiased population of stillborns was referred to WiSSP for ultimate diagnostic interpretation. As each of the first 789 cases was reviewed, the question was asked, "If this one segment of the evaluation had not been completed, would the diagnosis nonetheless have been made?" Each time the answer was "no" — that portion of the evaluation was judged to be diagnostically critical. All elements have been diagnostically critical:

We do understand, however, that not all families will agree to all parts of the evaluation. While we encourage every family to at least consider autopsy, we will accept any available data and do our best to provide answers for the family.

Critical Evaluations Chart

Return to protocol cover page.