Antenatal Care - Stillbirth

Question 1

What is Stillbirth?

Answer 1

Birth of a dead foetus (intrauterine foetal death) after week 24.

Question 2

Risk Factors of Stillbirth (6).

Answer 2

1. FGR.
2. Smoking & Alcohol.
3. Increased Maternal Age & Maternal Obesity.
4. Twins.
5. Supine Sleeping.
6. Pregnancy-Related Complications.

Question 3

Prevention of Stillbirth (3).

Answer 3

1. Serial Growth Scans : for SGA Risk Babies.
2. Aspirin : PET.
3. Checking for 3 Red Flags : Reduced Foetal Movements; Abdominal Pain; Vaginal Bleeding.

Question 4

Management of Stillbirth (4).

Answer 4

1. US - Investigation of Choice : Diagnosis of IUFD (Visualise Foetal Heartbeat). Repeat Scan due to passive foetal movements.
2. Anti-D Prophylaxis.
3. Vaginal Birth & Induction of Labour/Expectant Management.
4. Determine Cause with Parental Consent.

Question 5

Induction of Labour.

Answer 5

F-PSA :
1. Oral Mifepristone (Anti-Progesterone).
2. Vaginal/Oral Misoprostol (Prostaglandin Analogue).

Question 6

How can the underlying cause be deduced?

Answer 6

1. Genetic Testing of Foetus and Placenta.
2. Postmortern Examination of Foetus.
3. Testing for Maternal and Foetal Infection.
4. Testing Maternal Co-morbidities.