Stillbirth: Causes, Symptoms, Diagnosis, and Management

Stillbirth: Causes, Symptoms, Diagnosis, and Management

Stillbirth is a devastating event for mothers when a baby dies in the womb before the 37th week of pregnancy. This article will provide basic information about stillbirth, including its causes, symptoms, diagnosis, and management.

Causes:

Stillbirth can be caused by various factors, both from the mother and the baby.

• From the mother:

• Chronic illnesses: Diabetes, high blood pressure, heart disease, blood clotting disorders, infections, systemic lupus erythematosus, etc.

• History of miscarriage, stillbirth, premature birth, etc.

• Age: Both very young and older mothers are at higher risk.

• Poor nutrition, strenuous work, smoking, alcohol consumption, etc.

• From the baby:

• Birth defects: Heart defects, anencephaly, gastrointestinal defects, etc.

• Chromosomal abnormalities: Down syndrome, Turner syndrome, etc.

• Umbilical cord knotting, placental abruption, etc.

• Blood group incompatibility between mother and baby, etc.

Symptoms:

The symptoms of stillbirth depend on the gestational age at which the baby dies.

• Under 12 weeks:

• Heavy, persistent, and continuous vaginal bleeding.

• The uterus may be normal in size.

• No fetal heartbeat on ultrasound.

• hCG levels do not double after 48 hours.

• Under 20 weeks:

• Heavy, unclotted vaginal bleeding.

• Occasional abdominal pain.

• No fetal movement.

• The abdomen does not grow or may even shrink.

• Over 20 weeks:

• No fetal movement.

• The uterus feels soft and does not correspond to the gestational age.

• No fetal heartbeat.

• Brownish-black vaginal bleeding.

• Leakage of colostrum.

• Ultrasound shows no fetal heart activity.

• X-ray may show signs of skull overlapping.

Diagnosis:

• Ultrasound: This is the most accurate diagnostic method and can determine fetal heart activity, fetal image, and other abnormalities.

• hCG levels: Can help diagnose stillbirth in the early weeks of pregnancy.

• X-ray: May show signs of skull overlapping, fetal scalp detachment, fetal scalp air bubbles, etc.

Management:

• Under 8 weeks:

• Dilation and curettage is the main treatment.

• Under 20 weeks:

• Dilation and curettage or medical abortion.

• Over 20 weeks:

• Induction of labor with medication to deliver the baby.

• Cesarean delivery if indicated.

Complications:

• Blood clotting disorders: This is a common complication due to the release of breakdown products from the baby into the mother’s bloodstream.

• Infection: Can occur if the amniotic sac ruptures for a long time.

• Postpartum hemorrhage: Due to uterine atony or retained placenta.

Notes:

• Stillbirth is a devastating event for mothers. Emotional and psychological support is essential.

• The mother’s health should be closely monitored after a stillbirth.

Recommendations:

• Have regular prenatal appointments to detect stillbirth early.

• Follow your doctor’s instructions to prevent stillbirth.

• Seek emotional and psychological support from family, friends, or healthcare professionals.

In conclusion, stillbirth is a serious issue that can affect any pregnant woman. Understanding the causes, symptoms, and management can help mothers and families cope with this event in the best way possible.