Stillbirth

Question 1

Define stillbirth

Answer 1

death of the foetus after 24 weeks gestation

Question 2

how commonly is stillbirth unexplained?

Answer 2

50% of the time

Question 3

3 pre-existing conditions which increase the risk of stillbirth

Answer 3

diabetes

thyroid disease

thrombophilia

Question 4

7 risk factors for stillbirth

Answer 4

multiple pregnancy

smoking

alcohol

increasing maternal age

sleeping lying on the back (as opposed to the sides)

maternal obesity

foetal growth restriction

Question 5

true or false: SGA increases the risk of stillbirth

Answer 5

true

Question 6

3 symptoms that could suggest IUFD

Answer 6

reduced foetal movements

PV bleeding

abdominal pain

Question 7

how is IUFD diagnosed?

Answer 7

USS can visualise foetal heartbeat (or confirm that it isn’t there)

Question 8

true or false: foetal movements makes IUFD impossible

Answer 8

false; there can be passive movement after foetal death

Question 9

is IUFD a sensitising event?

Answer 9

yes

Question 10

how should stillbirth be managed?

Answer 10

vaginal delivery is preferred; induction can be performed

Question 11

how is induction of labour performed in the context of IUFD?

Answer 11

both mifepristone and misoprostol are used

Question 12

how can lactation be suppressed following IUFD?

Answer 12

cabergoline is the medication of choice

Question 13

4 sets of investigations carried out after IUFD

Answer 13

genetic testing of the foetus and placenta

postmortem examination of the foetus

testing for maternal and foetal infection

testing for maternal diabetes, thyroid disease, thrombophilia