Intrauterine fetal demise in term infants was studied in 4 cases and a sequence of fetal heart rate changes preceding intrapartum death was suggested. Late or variable decelerations, if unrelieved or uncorrected, lead to baseline heart rate changes of tachycardia and loss of variability reflecting loss of fetal reserve and fetal distress. This is followed by an unstable heart rate, a sinusoidal pattern or a rapidly changing fetal heart rate. The final event is a profound bradycardia just prior to fetal demise.