Stillbirth
A stillbirth is
defined as intrauterine death followed by the birth of a developing child that
occurs after 20 completed weeks of gestation. A stillbirth occurs in about 1 in
160 pregnancies. Most stillbirths occur before delivery, and a small percentage
occur during delivery.
Why do stillbirths happen?
If you have had a
stillborn baby or are supporting someone through this difficult experience, you
are probably desperate to find out why this happened. An autopsy is usually the
best way to diagnose the cause of a stillbirth, but it is not always a standard
procedure. Ask about your hospital's procedures for handling stillborn babies
and the cause of death. If refusing an autopsy is normal, find out how you can
ask if you and your family want it.
The most common known
causes include:
- Placental problems: Women with placental abruption, or a form of
pregnancy-related high blood pressure called preeclampsia or pregnancy-induced
hypertension, have twice the risk of abruption or stillbirth than women without
the condition. Sometimes a lack of oxygen and nutrients can also contribute to
the death of the baby.
- Birth defects: Chromosomal abnormalities account for 15 to 20% of all
stillborn babies. Sometimes a child has structural defects that are not caused
by chromosomal abnormalities, but may be the result of genetic, environmental,
or unknown causes.
- Growth restriction: young children or children who do not grow at an
appropriate rate are at risk of dying from suffocation (lack of oxygen) before
and during birth, or from unknown causes.
- Infections:
Bacterial infections between 24 and 27 weeks of gestation can cause fetal
death. These infections usually go unnoticed by the mother and may go
undiagnosed until they cause serious complications.
- Other rare causes of stillbirth include cord injury, trauma, maternal
diabetes, high blood pressure, and postterm pregnancy (pregnancy that lasts
more than 42 weeks).
Unfortunately,
despite attempts to find the cause, in about a third of stillbirths, the cause
cannot be determined.
What factors increase the risk of stillbirth in a mother?
- Women 35 years old or older
- Malnutrition
- Inadequate prenatal care
- Smoking
- Alcohol and drug abuse
- African-American ethnicity
How is the diagnosis made?
Most women usually
notice that their child is inactive and worry about what this might mean.
Ultrasound can confirm that the baby has died, and in some cases determine the
cause.
Can stillbirth be prevented?
Medical advances have
reduced the number of stillbirths. Today, women with high-risk pregnancies are
closely monitored with routine ultrasounds and/or fetal heart rate monitoring.
If potential problems are identified, early delivery may be required.
Here are the steps
you can take to prevent a stillbirth:
Daily " kick count".
From 26 to 28 weeks pregnant, take time each day to record your baby's
movements. If you get used to what is normal for your child, you are more
likely to notice when something is not right. If you notice a sudden decrease
in mobility, see your doctor. An ultrasound can usually confirm if there are
any potential problems.
Avoid drugs, alcohol,
and smoking as they can increase the risk of stillbirth and other pregnancy
complications. Seek immediate medical attention if you experience vaginal
bleeding during the second half of your pregnancy.
If you have had a stillbirth in the past, future pregnancies should be closely monitored so that all necessary steps can be taken to prevent recurrent pregnancy loss.
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