Knowledge | Stillbirth: Causes, Symptoms, and Prevention



Knowledge | Stillbirth: Causes, Symptoms, and Prevention


Definition, Possible Causes, and Management

Stillbirth is the death and delivery of a fetus after 20 weeks of pregnancy. Loss before 20 weeks is called miscarriage. Stillbirth occurs in about 1 in 200 pregnancies and can be devastating, particularly when the pregnancy previously appeared normal.


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Most women who experience stillbirth later have a healthy baby. Recurrence is less likely when the cause is a chromosomal abnormality or umbilical cord problem, but risk is higher with chronic maternal disease or inherited parental conditions. Overall, the chance of a subsequent healthy pregnancy is over 90%.


Possible Causes

About half of stillbirths have no identified cause. Known causes include:


Birth defects, with or without chromosomal abnormalities;

Umbilical cord problems such as prolapse, knots, or entanglement that interrupt oxygen supply;

Placental problems such as placental abruption;

Maternal conditions such as diabetes or pregnancy-related hypertension (preeclampsia);

Intrauterine growth restriction (IUGR), which raises the risk of death from inadequate nutrition;

Severe nutritional deficiency or infection;

Environmental toxins such as pesticides or carbon monoxide;

A personal or family history of clotting disorders.


Risk Factors

Risk may be higher with:


A previous stillbirth;

Smoking, heavy alcohol use, or drug misuse;

Obesity;

Maternal age under 15 or over 35.


Symptoms and Management

Stillbirth often has no warning signs, but possible signs include:


Vaginal bleeding, especially abnormal bleeding later in pregnancy, which requires immediate medical attention;

Reduced fetal movement or a change in movement patterns, which requires prompt evaluation.

After a stillbirth, doctors may recommend fetal autopsy and genetic testing to identify the cause and assess future risk. Results may provide answers and emotional reassurance.


If a genetic cause is found, consultation with a genetics specialist may help clarify risks in future pregnancies.


Prevention

Many stillbirths occur without clear risk factors, but risk may be reduced by:


Close monitoring of high-risk pregnancies, including frequent prenatal visits and fetal monitoring for patients with diabetes or hypertension;

Tracking fetal movement, particularly after 26 weeks, and seeking care promptly if movement decreases;

Maintaining a balanced diet, moderate exercise, and taking 400-800 micrograms of folic acid;

Avoiding smoking and alcohol;

Preventing infection by avoiding undercooked food, raw meat, and unpasteurized cheese;

Installing a carbon monoxide detector.

Stillbirth can be psychologically overwhelming. Professional counseling and support groups can help families process grief and rebuild confidence.


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