Stillbirth Flashcards

1
Q

How should pregnancy be managed?

A

Assess maternal wellbeing and ensure prompt management of any potentially life threatening maternal disease

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2
Q

What should pregnant mothers be examined for?

A

Pre-eclampsia, chorioamnionitis and placental abruption

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3
Q

What should women who are RhD negative be advised to do?

A

Have a Kleihaner test to detect any large feto-maternal haemorrhage

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4
Q

How quickly should anti-RhD gammaglobulin be given after presentation?

A

As soon as possible

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5
Q

What is a stillbirth?

A

When a baby dies after 24 weeks of pregnancy

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6
Q

What is a miscarriage?

A

Loss of a baby < 24 weeks pregnancy

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7
Q

When does antepartum refer to?

A

Before labour

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8
Q

When does intrapartum refer to?

A

During labour

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9
Q

What can MBRRACE reviews lead to?

A

Change in government policy and redistribution of resources

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10
Q

In what ethnic group are still births more common in?

A

BAME = 80% higher risk in black babies, 60% higher risk in asian babies

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11
Q

What area does MBRRACE recommend extra emphasis be placed on?

A

Reducing preterm birth

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12
Q

What are the most common causes of intrapartum death?

A
Placental abruption
Maternal and foetal infection
Cord prolapse
Idiopathic hypoxia-acidosis
Uterine rupture
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13
Q

What are some risk factors for stillbirth in the UK?

A

Placental cause or intrauterine growth restriction
Extremes of age and lifestyle factors
Obesity and diabetes
Prolonged pregnancy and previous stillbirths

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14
Q

What are the most common reasons for babies dying?

A

Unknown cause = 46%
Placental problems = 22%
Congenital abnormalities = 6%
Complications during labour = 6%

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15
Q

What is the UK government target?

A

Aims to reduce stillbirth by half by 2025

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16
Q

What are some ways the UK government is trying to reduce stillbirths?

A

Ensure women are cared for by the same midwife
Roll out of maternity outreach clinics
Smoking cessation programmes

17
Q

What is the purpose of the Moments Matter movement?

A

To tell women to get in touch with medical professionals if there is a reduction in foetal movement = discussed at 24 week appointment

18
Q

What are some of the recommendations made by Tommy’s?

A

Going to sleep on side in 3rd trimester
Smoking cessation
Avoiding alcohol and drugs
Staying a healthy weight throughout pregnancy
Attending appointments
Contact hospital in leaking fluids/vaginal discharge

19
Q

What is the PMRT tool?

A

Local review of all perinatal deaths from 22 weeks gestation to 28 days after birth as well as babies who die after 28 days following neonatal care

20
Q

What are some situations where immediate delivery would be recommended?

A

Sepsis, pre-eclampsia, placental abruption or membrane rupture

21
Q

What is the recommended mode of delivery for most women?

A

Vaginal delivery

22
Q

What is there a moderate risk of during labour?

A

Maternal disseminated intravascular coagulation (DIC)

23
Q

How is maternal DIC tested for?

A

Clotting studies, blood placental count and fibrinogen measurement

24
Q

What should women who delay labour by > 48 hrs be advised to do?

A

Have weekly testing for DIC

25
What are some investigations that can be done?
Infection screening and genetic testing Maternal antibodies and maternal wellbeing Post mortem is gold standard
26
What are some investigations that may be part of a debrief?
Post mortem, skin biopsy, placental histopathology, blood test and microbiology
27
What are mothers who have had a stillbirth at higher risk of?
4x higher risk of depression | 7x higher risk of PTSD
28
What are some things that are involved in planning another pregnancy following a stillbirth?
Plan depends on previous cause of stillbirth (if known) Likely to involve frequent foetal surveillance and tests May involve medication Likely early delivery by IOL