The relationship between fetal death and maternal injury is a medical and legal issue of increasing importance. Many State statutes make it a criminal act to cause the death of a fetus by injuring the mother. The most common cause of traumatic fetal death is death of the mother. Maternal death or serious injury can result in fetal death even if the fetus is not directly injured. Accidents due to motor vehicle collisions are by far the most common cause of severe injury and traumatic death in pregnant women. Violent assaults, usually with firearms, are the second most common cause and are increasing. Various types of injury to the abdomen may cause fetal loss even when the mother survives a trauma incident. Blunt abdominal trauma during pregnancy most commonly results from motor vehicle accidents, followed in frequency by falls and assaults. In addition to blunt force injuries, sharp force injuries to the pregnant uterus by such objects as pitchforks, scythes, animal horns, sickles, and knives have been described. The authors present two cases in which fetal death resulted from maternal trauma. In addition, they review the pertinent literature on the subject and offer guidelines that may help forensic pathologists evaluate these difficult and often emotionally charged cases. 15 references (Author abstract modified)