Stillbirth Flashcards
define stillbirth
when a baby dies after 24 weeks gestation, before or during birth
define miscarriage
loss of a baby before 24 weeks gestation
when is the term late miscarriage used
loss of a baby between 22-24 weeks
list some risk factors for stillbirth
placental causes IUGR congenital abnormalities maternal infections nutrition and lifestyle factors extremes of age PET and eclampsia obstetric cholesatsis multiple pregnancy - TTTS >42 weeks gestation obesity smoking in pregnancy antepartum haemorrhage antibodies ethnicity - black/asian babies poor socioeconomic class
causes for intrapartum stillbirth
placental abruption infection cord prolapse idiopathic hypoxia-acidosis uterine rupture
what is a sign that your baby is doing well
regular foetal movements
how should women sleep in their 3rd trimester
on their side
what lifestyle modifications should be made prior to pregnancy and throughout
healthy BMI
folic acid + vit D
smoking cessation
no alcohol or drugs
which vaccinations should mother get in pregnancy
flu and whooping cough
what investigations can be done to assess maternal wellbeing
examine for PET, chorioamnionitis, placental abruption
Kleihauer test for anti-D
what is a Kleihauer test
assesses if there was mixing of maternal and foetal blood and the need for more anti-D
how can the baby’s blood group be assessed
blood sample from the umbilical cord
how can you deliver a stillborn baby and which is more recommended
c-section
vaginal delivery - recommended
what is the mother at risk of if labour is delayed
infection and DIC
the longer the baby stays inside the mother, the better/worse the value of the post mortem
worse
how can you induce labour for women with a stillborn baby
mifepristone and misoprostol
what investigations can be done to identify the cause of stillbirth after labour
post mortem skin biopsy placental histology maternal glucose, TFT and thrombophilias microbiology antibodies karyotyping toxicology
how long can it take before the results of the post mortem are complete
6-8 weeks
what mental health conditions are women at risk of who delivered a stillborn baby
PTSD
depression
how should you approach a woman wanting to try for another pregnancy after a previous stillbirth
depends on previous cause eg continuity of care, more frequent appointments, increased surveillance, tests and scanning OGTT, BP, urinalysis aspirin, fragmin IOL
what is grief
individual response to loss where bereaved adjust to life without the deceased
what are the stages of grief
denial anger depression bargaining acceptance
consent is needed from the procurator fiscal before removing IV lines, clothing etc from the baby, true or false
true
who does the bereavement service support
miscarriages >14 weeks
TOP for congenital abnormalities only
stillbirth
neonatal death
what are some counselling methods
CBT psychodynamic complicated grief therapy memory building memorial services
