Stillbirth Flashcards
What is a stillbirth?
Baby dies after 24 weeks of pregnancy and before or during birth
When does a miscarriage become a stillbirth?
Loss of a baby before 24 weeks is classed as a miscarriage
Many mums who have a late miscarriage (22-24 weeks) can be classed as a stillbirth
How frequent is stillbirth?
1 in every 200 pregnancies ends in stillbirth
8 babies born every day in the UK are stillbirth
Of those born stillborn, 1 in 3 are over 37 week
What are some risk factors and causes for stillbirth in the UK?
Placental - abruption IUGR Congenital anomalies Infection Cord prolapse Idiopathic hypoxia-acidosis Uterine rupture (common after previous c/s) Lifestyle factors Extremes of age PET Diabetes Obstetric cholestasis Multiples; TTTS >42 weeks Obesity Smoking Previous still birth Antepartum haemorrhage Anti-D
What foods should be avoided in pregnancy?
Soft-mould ripened and soft blue-veined cheese
Raw/undercooked shellfish and meat
Eggs that are not british lion quality marked
Vit A supplements; fish liver oil
Liver and products that contain liver such as pate
Raw fruit and veg not washed
How should you sleep in the 3rd trim, safest for baby?
On side
Lying on back can put pressure on the womb and main blood vessels supplying them restricting blood flow
For women who are rhesus D neg and have a stillbirth, what is recommended?
Kleihauer test to detect large fetomaternal hemorrhage that might have occurred a few days earlier
Anti-D administration ASAP
If large FMH, dose of anti-D should be adjusted upwards and Kleihauer test repeated at 48 hours to ensure that foetal red cells have cleared
How is labour induced in stillbirth?
Mifepristone
Misoprostol
How soon after confirmation of stillbirth should induction ideally be achieved?
48 hours
What investigations can be sent to help determine cause of IUFD?
Post mortem Skin biopsy Placental histopathology Bloods; infection screen, thrombophilia, blood group, diabetes, thyroid Microbiology
What is the outcome if a mother has an IUFD and then is confirmed to have thrombophilia?
Fragmin administered in future pregnancies
Are there impacts on maternal mental health post stillbirth?
4x more likely to have depression
7x more likely to have PTSD
If a chromosomal abnormality is detected on the investigations performed on the deceased foetus, what can be performed in the next pregnancy?
Non invasive prenatal testing
