8.24 Stillbirth Flashcards
1
Q
What proportion of pregnancies result in stillbirth?
A
1 in 200
death after 24 weeks. (IUFD - intrauterine fetal death)
2
Q
What are some causes of stillbirth?
A
- Unexplained (around 50%)
- Placental abruption
- Vasa praevia
- Cord prolapse or wrapped around the fetal neck
- Pre-eclampsia
- Obstetric cholestasis
- Diabetes
- Thyroid disease
- Infections, such as rubella, parvovirus and listeria
- Genetic abnormalities or congenital malformations
3
Q
What factors increase the risk of stillbirth?
A
- FGR
- Smoking
- Alcohol
- Increased maternal age
- Maternal obesity
- Twins
- Sleeping on the back (as opposed to either side)
4
Q
What are 3 key symptoms of stillbirth?
A
- Reduced fetal movements
- Abdominal pain
- Vaginal bleeding
5
Q
How do you manage stillbirth?
A
US scan for fetal heart beat. Repeat as passive movement can be felt later.
antiD for Rh-ve with Kleihauer test
vaginal birth is first-line choice:
- IOL or
- expectant
IOL is mifepristone and misoprostol
dopamine agonists (cabergoline) to suppress lactation
parental consent for testing (genetic, infection, X-rays, maternal conditions)
breaking bad news and counselling
support wishes for seeing, photographs, funeral etc
