Objective: To identify main causes of unchanged stillbirth rate in the Czech Republic. Design: Nationwide retrospective analysis of stillbirth. Setting: Institute for the Care of Mother and Child, Prague-Podoli. Methods: Analysis of relationship of selected data on antenatal stillbirth cases of singleton fetuses with birth weight 2000 grams and more without congenital malformations. Results: Among 151 women with stillborn babies who died after 31st week (differentiated to groups of pathological pregnancy, risk pregnancy and no-risk) 30 selected data items were collected. Conclusions: Prevailing insufficiency of out-patient care was no-referal or late refferal to hospital care, especially among women with pathological course of pregnancy (this is insufficiency in organization of care). On the other hand, the most prevailing insufficiency in hospital care was the underestimation of severity of pathological pregnancies and a return of patients to out-patients care or in case of hospitalization the late decision about termination of pregnancy. Using the results of the analysis the possibility to avoid an intrauterine death was quantified at the level of 0.3‰, which would have impacted on possible decrease of stillbirth rate from 2.7‰ to 2.33‰.

        Key words: pathological pregnancy, risk pregnancy, in-patient care, out-patient care, insufficiency of care – organizational, hospital care, avoidance of death