Stillbirth Flashcards
What defines a stillbirth?
Babies born dead (that were alive) after 24 weeks completed gestation
What is the stillbirth rate in the UK?
1:200 total births
Some hours after fetus has died in utero, what happens to their skin?
Begins to peel - at delivery described as macerated
If left, spontaneous labour occurs in…
80% in 2 weeks
90% within 3 weeks
What is a risk with late intrauterine death?
Coagulopathy occurs in 10% within 4 weeks, 30% thereafter
What causes are there?
No cause found in 28% Placental causes 12% APH/IPH 11% Major congenital anomaly 9% Infection HTN in pregnancy Maternal disease - renal, DM IUGR Mechanical e.g cord prolapse, knot in cord
What factors can increase the incidence?
Increased maternal age Smoking Previous CS IVF Obesity
How is it diagnosed?
Mother usually reports reduced fetal movement
No fetal heart sounds = unreliable
Diagnosis = by absent fetal heart beat on USS
How is it managed?
If mother rhesus neg give anti D
Do Kleinhauer to diagnose fetaomaternal haemorrhage - a cause of stillbirth
Check mother BP, urine, temperature
Deliver baby - vaginal encouraged, by CS may be necessary
Why is a vaginal delivery encouraged?
CS has increased risks for further pregnancy
If not induced after 48 hours, what should be checked twice weekly?
Coagulopathy
Is a post-mortem offered?
Yes as may affect management of further pregnancies
