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Stillbirth (IUFD) — 2025 guideline
Diagnosis, birth, investigations and support.
Source: RCOG GTG 55 (2025)Check BP, infection and clotting (DIC) at diagnosis, especially if the baby died some time ago.
Induction
MifepristonePriming200 mg orally.⚠ Then misoprostol by gestation.
Misoprostol24+0–24+6 wk400 µg every 3 hours.
Misoprostol25+0–27+6 wk200 µg every 4 hours.
MisoprostolFrom 28 wk25–50 µg vaginally every 4 hours, or 50–100 µg orally every 2 hours.⚠ After 1 previous CS considered safe; more than 2 CS needs a specialist plan.
Investigations
- FBC, U&E, LFT, CRP, TFT, clotting, bile acids, glucose and HbA1c.
- Kleihauer for all women; red cell antibodies.
- Infection screen: cultures, swabs, TORCH, parvovirus.
- Antiphospholipid antibodies; anti-Ro/La if indicated.
- Offer postmortem, placental histology and genetics (written consent).
After birth
CabergolineStop milk1 mg single dose on day 1.⚠ Avoid in hypertension or pre-eclampsia.
Anti-DRh-negativeDose guided by Kleihauer.
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.