stillbirth and perinatal morbidity

Question 1

what is a still birth ?

Answer 1

a baby that is born without any signs of life but with the condition of having completed at least 24 weeks of pregnancy

Question 2

what is intrauterine fetal death ?

Answer 2

refers to babies with no signs of life intra uterine

Question 3

what are the alarming signs that could predispose to still births ?

Answer 3

daily fetal movement count
rupture of membranes
vaginal bleeding
abdominal pain

Question 4

what is the normal fetal movement count ?

Answer 4

more than 10 kicks per 12 hours

Question 5

what investigations could be performed for high risk cases ?

Answer 5

CTG
ultrasound with doppler
Labs

Question 6

what is the most preferred method of delivery in cases of IUFD ?

Answer 6

vaginal birth is preferred

Question 7

how should labour be induced with women who have been diagnosed with IUFD ?

Answer 7

induction of labour starts with a single dose of mifepristone then send home
admit 36-48 hours later for misoprostol induction of labour

Question 8

what investigations for the fetus must be performed after the delivery process in IUFD/still birth ?

Answer 8

postmortem

placental histopathology

Question 9

what is included in postmortem investigations ?

Answer 9

external examination
pathological examination
minimally invasive examination such as needle biopsy

Question 10

what is the next best step is post mortem is declined ?

Answer 10

offer limited external examination

Question 11

if there were too many megakaryoblasts to be found in the fetal blood in post mortem examination what is the most likely cause of the still birth ?

Answer 11

congenital leukemia - megakaryoblastic leukemia

Question 12

what genetic disorder is commonly associated with congenital leukemia ?

Answer 12

trisomy 21

Question 13

what external features of the baby may be suggestive of ctrisomy 21 ?

Answer 13

dysmorphic face
abnormal palmar and plantar creases
atrioventricular septal defects