Stillbirth is a term used if the unborn fetus dies in the mother’s womb at 20 weeks of pregnancy or more. Loss of pregnancy prior to 20 weeks of gestation is termed as miscarriage. Stillbirths are mostly seen to occur after 24 weeks of pregnancy but a small percentage is noticed during the onset of labor and delivery. Statistics reveal that stillbirths can happen in 1 pregnancy out of a 100, and unless the causes are genetic, most women will be able to give birth to healthy babies in the next pregnancy. The chances of having a successful further pregnancy ranges to about 90%.
The condition is very overwhelming for the mother. Because it generally happens in pregnancies which are deemed normal, the fact that the unborn has died in the womb is heart wrenching for the parents.
Placental complications cause about half of all stillbirths. Placental abruption(the separation of placenta from the womb), problems with the umbilical cord, mother’s health that may result in pre-eclampsia, genetic physical defects in the baby and pre-existing diabetes in the mother can also cause the baby to be born still. Pregnancy above the age of 40, addiction to illegal drugs and being overweight and obese can also be probable causes of stillbirth.
Some other causes of stillbirth are as follows:
The true causes of stillbirth are not clear in spite of thorough investigations It is also seen that sometimes more than two causes are accountable for fetus death.
A handheld Doppler device or an ultrasound scan will be performed if your doctor has any doubts that the baby has died in the womb. In the event the doctor cannot hear the baby’s heartbeat, an ultrasound will be done to confirm of the baby has died. Blood tests may also be recommended. In case the baby has died, and there is no immediate health risk for you, you may take some time to think whether you want to wait for labor or labor be induced.
The most important point for a pregnant woman to keep in mind is the perception of fetal movements. Whether the fetus is moving with the uterus or not is an important point in diagnosing stillbirth. Fetal heart sound is checked with the aid of the Doppler and is also clinically assessed by the stethoscope on every prenatal visit. Doubts, if any are immediately cleared by ultrasonograph. Fetal movements and ultrasound are the main diagnostic tools for the diagnosis of stillbirth.
This is devastating to the parents. Exceptional support and care should be provided to the parents, especially the mother.
Immediate delivery is required in women with some medical reasons. But in other cases the natural onset of labor is waited for. The care provider closely keeps a watch to check that there is no blood clotting issue or infection develops. A c-section is not usually done.
Mostly women opt for induced labor as soon as they come to know about the death of the fetus. The doctor may give you medications and you can go to your home and wait for labor to set through the induction process.
Some women prefer to wait for natural labor, though doctor will advise blood tests after 48 hours. The baby can deteriorate in the womb, making it difficult for the doctors to ascertain the cause of the death.
Cervix is dilated with the help of medicines in the vagina by the caregiver. Subsequently oxytocin IV drip is given to stimulate the contractions of the uterus. Most of the women deliver vaginally by this process.
D&E or dilatation and evacuation is the process done for women in second trimester whereby she is sedated under IV or general anesthesia and the cervix is dilated and baby is removed. Following are the factors that have to be pondered and taken into consideration while choosing between delivery and D&E:
Autopsy of the baby is done to investigate any clue responsible for the actual cause of death of the baby. Therefore autopsy must be done.
Most still-births happen to healthy pregnant women. Prevention is also difficult as many causes of still birth are yet unknown. If you notice any bleeding per vaginum in the second and third trimester of pregnancy, immediately visit your doctor. This can be an alarming sign of placental abruption. Any uterine tenderness, off and on uterine contractions, back pain, cramp like abdominal pain and decreased fetal movements are some of the important signs should be kept in mind and if any of these are noticed, immediately consult your obstetrician and take the required precautions and medications.
When you are in mid trimester of pregnancy, be very particular about fetal movements and any of the above mentioned alarming signs. You can cut down your risk of having stillbirth by keeping in mind following points.
Though stillbirth can happen to a normal healthy women, some conditions do put you at a higher risk of having a still-born baby. A history of preterm birth, pregnancy-induced hypertension, or pre-eclampsia, a previous stillbirth or a complicated pregnancy can increase the odds of having a stillbirth. Chronic medical conditions like thrombophilia (a blood clotting disorder), thyroid, hypertension, diabetes or a history of smoking or addiction to drugs can also result in stillbirth.
Guilt is generally a common reaction to a still birth, but be assured the chances of causing a stillbirth due to something that you did or you did not do are practically very rare. A sense of deep grief, anger, pain, resentment and confusion may play havoc with your marriage as well your life. Though it is a very trying and emotionally depleting experience, you need to be strong and positive.