Stillbirth
Death of a fetus in the womb after a certain gestational age
Stillbirth | |
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Synonyms | Intrauterine fetal demise, late fetal loss |
Pronounce | |
Field | Obstetrics, Neonatology |
Symptoms | Absence of fetal movement, absent fetal heartbeat, abnormal ultrasound findings |
Complications | Emotional distress, postpartum complications, infection |
Onset | Usually after 20–24 weeks of gestation |
Duration | Permanent loss |
Types | Early stillbirth, late stillbirth, term stillbirth |
Causes | Unknown (many cases), placental issues, umbilical cord complications, infections, genetic factors |
Risks | Advanced maternal age, obesity, smoking, hypertension, diabetes |
Diagnosis | Ultrasound, absence of fetal heartbeat, Doppler scan |
Differential diagnosis | Miscarriage, intrauterine growth restriction, preterm labor |
Prevention | Prenatal care, managing maternal health conditions, monitoring fetal movements |
Treatment | Induced labor, cesarean delivery (if necessary) |
Medication | N/A |
Prognosis | Emotional and physical recovery varies |
Frequency | 1 in 115 births (United States), higher in low-income regions |
Deaths | N/A |
A stillbirth is the death of a fetus inside the mother's womb after 20 to 24 weeks of pregnancy (depending on country-specific definitions) or during childbirth. When the fetus is delivered, it is called stillborn. Stillbirth differs from a miscarriage, which occurs earlier in pregnancy.
Classification[edit | edit source]
Stillbirths are categorized based on gestational age:
- Early stillbirth – occurs between 20–27 weeks of pregnancy.
- Late stillbirth – occurs between 28–36 weeks of pregnancy.
- Term stillbirth – occurs at 37 weeks or later.
Causes[edit | edit source]
The exact cause of stillbirth is unknown in many cases, even after thorough investigation. However, several known factors can contribute to stillbirth, including:
1. Maternal Health Conditions[edit | edit source]
- Diabetes
- High blood pressure (preeclampsia, eclampsia)
- Obesity
- Autoimmune disorders
- Infections during pregnancy (e.g., syphilis, cytomegalovirus, listeriosis)
- Substance abuse – Smoking, alcohol, and drug use increase the risk.
2. Placental and Umbilical Cord Problems[edit | edit source]
- Placental abruption – The placenta separates from the uterus before birth.
- Insufficient placental function – Poor blood supply to the fetus.
- Umbilical cord accidents – Cord compression, knots, or prolapse.
3. Fetal Factors[edit | edit source]
- Congenital anomalies – Genetic disorders or structural abnormalities.
- Infections – Sepsis, viral infections.
- Fetal growth restriction (IUGR) – Poor fetal development.
4. Environmental and External Factors[edit | edit source]
- Exposure to radiation
- Physical trauma (e.g., accidents, domestic violence)
- Chronic stress and poor prenatal care
Occurrence[edit | edit source]
The prevalence of stillbirth varies by country, healthcare access, and socioeconomic factors.
- United States – Approximately 1 in 115 births results in stillbirth, equating to around 26,000 cases annually (one every 20 minutes).
- United Kingdom – Around 1 in 200 births results in stillbirth.
- Australia – Similar to the UK, with rates of 1 in 200 births.[1]
- Developing Countries – Higher rates due to limited access to healthcare, malnutrition, and untreated infections.
Diagnosis[edit | edit source]
Signs and Symptoms
- Absence of fetal movements
- Lack of fetal heartbeat on ultrasound
- Cramping or pain
- Vaginal bleeding
- Abnormal fluid levels around the baby
Medical Evaluation 1. Ultrasound – Confirms the absence of fetal heartbeat. 2. Doppler scan – Checks for blood flow to the fetus. 3. Autopsy (optional) – Identifies potential causes.
Management and Treatment[edit | edit source]
Once stillbirth is diagnosed, delivery is necessary to prevent maternal complications such as infection and excessive bleeding.
Methods of Delivery
- Induced labor – Medication helps the mother deliver the baby vaginally.
- Cesarean section – Used in special cases (e.g., multiple previous C-sections).
- Expectant management – Waiting for labor to begin naturally.
Emotional and Psychological Effects[edit | edit source]
Losing a baby can cause grief, depression, anxiety, and PTSD in parents. Support includes:
- Counseling and therapy
- Support groups for grieving parents
- Medical follow-ups to monitor physical recovery
Legal Definitions of Stillbirth[edit | edit source]
Each country has different legal definitions and registration requirements for stillbirth.
United Kingdom[edit | edit source]
- Any baby born after 24 weeks of pregnancy with no signs of life is legally recorded as a stillbirth.
- A Stillbirth Certificate is issued to the family.[2]
Australia[edit | edit source]
- A fetus weighing more than 400 grams or older than 20 weeks must be legally registered.
United States[edit | edit source]
- The U.S. does not have a national stillbirth definition.
- Classification depends on state laws, but fetal deaths over 350 grams or 19 weeks are usually reported.[3]
Prevention[edit | edit source]
While not all stillbirths can be prevented, certain measures can reduce the risk:
- Regular prenatal checkups
- Monitoring fetal movements (kick counts)
- Managing maternal conditions (e.g., diabetes, high blood pressure)
- Avoiding alcohol, smoking, and drug use
- Sleeping on the side (after 28 weeks) – Reduces stillbirth risk by improving blood flow to the fetus.
After Stillbirth[edit | edit source]
- Families may choose to have a funeral or cremation.
- Many hospitals offer memory keepsakes such as handprints, footprints, and photographs.
- Special cemeteries exist for stillborn babies in some regions.
Research and Future Directions[edit | edit source]
Medical advancements aim to reduce stillbirth rates through:
- Improved placental monitoring via ultrasound.
- Genetic screening for early risk detection.
- Artificial womb technology – Experimental research on growing premature fetuses in artificial wombs.
See Also[edit | edit source]
References[edit | edit source]
- ↑ Department of Neonatal Medicine Protocol Book: Royal Prince Alfred Hospital Full text, Gordon, Adrienne (Dr), ,
- ↑ Guide to registering stillbirths in the UK
- ↑ {{{last}}}, Centers for Disease Control and Prevention, State Definitions and Reporting Requirements. online version, 1997 Revision edition, National Center for Health Statistics,
External Links[edit | edit source]
- Pregnancy Institute – Research on umbilical cord issues.
- March of Dimes: Facts on Stillbirth
- Stillbirth Stories – A Mother's Perspective
- Wisconsin Stillbirth Service Program
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