Stillbirth Flashcards
What is the definition of stillbirth?
Baby dies after 24 weeks of pregnancy and before or during birth.
During clinical examination for patient who had stillbirth, what 3 things are checked for?
Pre-eclampsia (hypertension during pregnancy).
Chorioamniotis (intra-amniotic infection).
Placental abruption.
Women who are Rh positive are advised to take a Kleinhauer test. True/false?
False, Rh negative are advised to take the test.
What is a Kleinhauer test?
A blood test used to measure the amount of foetal haemoglobin transferred from a foetus to the mother’s bloodstream.
Kleinhauer test explained?
Usually performed on Rh negative mother’s to determine the dose of RHO immunoglobulin to prevent formation of Rh antibodies in the mother and prevent Rh (rhesus) disease in future Rh - positive children.
Risk factors for stillbirth (UK)
Placental causes
Congenital abnormality - 6% stillbirths
Smoking
Previous stillbirth
Prolonged pregnancies
Obesity - one of the most important modifiable risk factors.
Lifestyle advice to reduce risk of stillbirth
Sleep on the side in the third trimester
Quit smoking and avoid alcohol and drugs.
Stay a healthy weight during pregnancy
Encourage patient to look after herself - attend check ups, get flu vaccination etc.
What is PMRT?
A comprehensive and robust local review of all pre-natal deaths from 22 weeks gestation to 28 days after birth as well as babies who die after 28 days following neonatal care.
Debrief arrangements for stillbirth?
Check on emotional and physical wellbeing of the mother and her partner, refer on if necessary.
Go through the results of any investigations that were sent.
Post-mortem
Skin biopsy
Points to consider for the next pregnancy?
Plan would depend on the previous cause if known.
Frequent contact with baby when born
Likely to involve more frequent foetal surveillance
Likely to involve more frequent maternal surveillance
Parent led and agreed decision making
