A stillbirth is when a fetus dies after the mother’s 20th week of pregnancy. The baby may have died in the uterus weeks or hours before labor or, less commonly, during the birth. A baby is stillborn in about 1 in 200 pregnancies
If the length of gestation (pregnancy) is not known, the birth will be considered a stillbirth if the baby weighs 400 grams or more.
When a baby shows no signs of life – is an extremely sad and distressing time for parents and family, as they deal with the shock, grief and pain of losing a baby. Often, the cause of a stillbirth or whether it could have been prevented is unknown. However, there are things you can do to lower the risk of having a stillbirth.
• Early stillbirth: The fetus dies between 20 and 27 weeks.
• Late stillbirth: The fetus dies between 28 and 36 weeks.
• Term stillbirth: The fetus dies the 37th week or after.
Difference between Stillbirth and Miscarriage –
Like a stillbirth, a miscarriage is also a pregnancy loss. However, while a stillbirth is the loss of a baby after 20 weeks of pregnancy, a miscarriage happens before the 20th week.
There are usually no warnings before a stillbirth. But the following symptoms could signal a problem:
• Vaginal bleeding, especially during the second half of pregnancy, may mean there’s a problem with your baby. If you have bleeding, call your doctor. But know that many women who have vaginal bleeding during pregnancy have no trouble carrying their babies to term.
• Lack of movement or a change in the normal activity level of your baby.
In about half of all cases, the cause of stillbirth is unknown. The causes of a stillbirth that are understood include:
• Birth defects,with or without a chromosomal abnormality: One or more birth defects are the cause of about 25% of stillbirths. Birth defects are rarely discovered without a thorough examination of the baby
• Problems with the umbilical cord; with a prolapsed umbilical cord, the cord comes out of the vagina before the baby, blocking the oxygen supply before the baby can breathe on their own. Or, the cord can knot or wrap tightly around a limb or the baby’s neck prior to delivery.
• Problems with the placenta; which nourishes the baby; in a placental abruption, the placenta separates too soon from the uterine wall.
• Medical Conditions of the mother like diabetes or high blood pressure, particularly pregnancy-induced high blood pressure, or preeclampsia
• Intrauterine growth restriction, or IUGR, which puts the fetus at risk of dying from lack of nutrition
• Severe lack of nutrition
• Infections during pregnancy: An infection between week 24 and week 27 can cause a fetal death. Usually, it’s a bacterial infection that travels from your vagina to the womb. Common bacteria include group B streptococcus, E. coli, klebsiella, enterococcus, Haemophilus influenza, chlamydia and mycoplasma or ureaplasma. Additional problems include rubella, the flu, herpes, Lyme disease and malaria, among others. Some infections go unnoticed until there are serious complications.
• Environmental agents: Exposure to environmental agents such as pesticides or carbon monoxide
• Clotting disorders: A personal or family history of blood clotting conditions like thrombosis, thrombophlebitis, or pulmonary embolism
• Trauma: Trauma such as a car crash can result in a stillbirth.
• Intrahepatic cholestasis of pregnancy (ICP): Also known as obstetric cholestasis, this is a liver disorder that includes severe itching.
• Lupus. A mother who has lupus is at risk of having a stillbirth.
• Lifestyle choices. If your lifestyle includes drinking, using recreational drugs and/or smoking, you’re more likely to have a stillbirth.
Risk Factors –
• A previous stillbirth
• Being under age 15 or over age 35
• Alcohol or drug abuse
• Have poor prenatal care.
• Are malnourished.
• Are having multiple births (twins or more).
An obstetrician or midwife will let you know if your baby is not showing any signs of life and will support you while they give you this news.
You will need to give birth to your baby and this, along with the news that the baby has died, is an extremely traumatic time for parents.
How can I find out what caused my stillbirth?
To discover the cause, your healthcare provider will perform one or more of the following tests:
• Blood Tests. Blood tests will show if you have preeclampsia, obstetric cholestasis or diabetes.
• Genetic tests. Your healthcare provider will take a sample of the umbilical cord to determine if your baby had genetic problems such as Down’s syndrome.
• Examination of the umbilical cord, membranes and placenta. These tissues attach to your fetus. An abnormality could prevent your baby from receiving oxygen, blood and nutrients.
• Tests for infection. Healthcare providers will take a sample of your urine, blood, or cells from your vagina or cervix to test for infection.
• Thyroid function test. This test will determine if there’s something wrong with your thyroid gland.
If your baby passes away before birth, there are usually several options for delivering the baby. In many cases, there is no need to do this immediately unless you have medical complications. However, your doctor will want to schedule a time in the near future for you to deliver. Most stillborn babies can be delivered vaginally after induction of labor, unless there are specific reasons for cesarean delivery.
After a stillbirth, as with other deliveries, you may experience breast engorgement, discomfort from an episiotomy, depression, and other problems. The combination of recovering physically and emotionally may seem overwhelming.
A stillbirth is an emotionally wrenching experience. A qualified counselor, psychologist, or psychiatrist can help you and your family through this difficult time.
Usually, a stillbirth cannot be prevented. It often occurs because the baby’s development was not normal. Helping improve the mother’s health, including managing preexisting conditions and lifestyle choices, improve the chances of a successful pregnancy.
These steps can help you have a healthy pregnancy:
• Exercise, eat well, and take 400-800 micrograms of folic acid daily, starting at least 1 to 2 months before getting pregnant.
• Avoid alcohol and smoking.
• Take only medications prescribed by your doctor. Never stop any medication without first discussing it with your doctor.
• Drive carefully and wear a seatbelt.
• Install a carbon monoxide detector in your home to prevent carbon monoxide poisoning.
• Avoid food poisoning and other infections. Stay away from ready-to-eat foods such as deli meats and fast foods. If you must eat these foods, be sure they’re heated thoroughly.
All pregnant women should keep track of the baby’s movements several times every day, regardless of other risk factors. This is especially important after the 26th week. If the baby kicks or moves less often, see a doctor right away or go to the hospital.
You’re also less likely to have a stillbirth if, when you know you’re high-risk, you’re carefully monitored through routine ultrasounds and/or fetal heart rate monitoring. If your healthcare provider finds a problem, they can have your baby delivered early if necessary.
For more informative articles about pregnancy and its complications, also on other health issues, please visit our website www.santripty.com and also feel free to consult.