Stillbirth
(Fetal Death; Intrauterine Fetal Death; IUFD)
Definition
Causes
- Chromosomal disorders
- Poor fetal growth
- Infection
- Complications of multiple gestation—being pregnant with more than one fetus
- High blood pressure or other conditions in the mother
- Rh incompatibility, which occurs when the mother has Rh-negative blood and fetus has Rh-positive blood
- Umbilical cord prolapse, which occurs when the umbilical cord descends into the vagina too early and cuts of oxygen to the fetus
- A loop or knot in the umbilical cord
- Placental abruption, which occurs when the placenta that nourishes the fetus separates from the uterus before the fetus is delivered
- Placenta previa, which occurs when the placenta becomes implanted near or over the cervix
Risk Factors
- Ethnicity: African American
- Age: 35 years of age or older
- Chronic condition, such as obesity , diabetes, high blood pressure , thyroid disease, kidney disease, heart disease, blood clotting disorder, or asthma
- Infection
- Smoking , drinking, or using drugs during pregnancy
- Multiple gestation
- First pregnancy
- History of stillbirth or miscarriage in a previous pregnancy
- Poor prenatal care
- Trauma, such as a car accident
Diagnosis
| Abdominal Ultrasound |
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Treatment
Therapy
Prevention
Before Becoming Pregnant
- Women should have a preconception visit with their doctor. Conditions like diabetes or high blood pressure should be treated and controlled.
- If a woman is overweight, her doctor can recommend a weight loss program. This can include a healthy diet and exercise .
- If a couple has a genetic trait, they can work with a genetic counselor who can help determine the chance that their child may inherit that condition.
During Pregnancy
- Go to all prenatal care visits.
- If a woman has had a prior stillborn baby, the doctor may do additional testing during the current pregnancy. Tests will be done to track how the fetus is developing. Some doctors may recommend that women monitor kick counts closely during their pregnancy.
- Smoking, drinking, and using drugs should be avoided during pregnancy.
- Women should call their doctor right away if they notice decreased fetal movement or have vaginal bleeding.
RESOURCES
American Academy of Pediatrics http://www.healthychildren.org
American Pregnancy Association http://www.americanpregnancy.org
CANADIAN RESOURCES
Health Canada http://www.hc-sc.gc.ca
Women’s Health Matters http://www.womenshealthmatters.ca
References
The American Congress of Obstetricians and Gynecologists. ACOG practice bulletin No. 102: Management of stillbirth. Obstet Gynecol. 2009 Mar;113(3):748-61.
Fetal death. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/ . Updated February 7, 2013. Accessed March 12, 2013.
Kent DR, West J. Obstetrics and gynecology: a modern approach to the management of intrauterine fetal death. West J Med. 1977;126(4):298-299.
Ogunyemi D. Stillbirths. Cedars-Sinai website. Available at: http://cedars-sinai.edu/Medical-Professionals/Graduate-Medical-Education/Residency-Programs/Obstetrics-and-Gynecology/Didactic-Program/Documents/stillbirth-officepresentation-85767.pdf . Accessed March 12, 2013.
Stillbirth. The Children’s Hospital of Philadelphia website. Available at: http://www.chop.edu/healthinfo/stillbirth.html . Accessed March 12, 2013.
Stillbirth: trying to understand. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/pregnancyloss/sbtryingtounderstand.html . Updated January 2013. Accessed March 12, 2013.
12/30/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Stillbirth Collaborative Research Network Writing Group. Association between stillbirth and risk factors known at pregnancy confirmation. JAMA. 2011;306(22):2469-2479.
12/30/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Stillbirth Collaborative Research Network Writing Group. Causes of death among stillbirths. JAMA. 2011;306(22):2459-2468.