Stillbirth - Types, Causes, Diagnosis and Prevention

What Is Stillbirth?

When the fetus dies after 20 weeks of pregnancy, it is called a stillbirth. The baby may die in the uterus during labor, a few hours after delivery, or weeks before delivery. Good prenatal care helps to avoid stillbirth, but in most cases, the reasons are unclear if it occurs.

How Is Stillbirth Different From a Miscarriage?

Although both miscarriage and stillbirth are a loss of a baby, miscarriage happens before the twentieth week, while stillbirth occurs after 20 weeks.

What Are the Types of Stillbirth?

Depending on the number of weeks of pregnancy, stillbirth is classified into the following:

• Early Stillbirth: When stillbirth occurs between the 20th week and 27th week, it is early stillbirth.

• Late Stillbirth: In late stillbirth, the fetus dies between the 28th and 36th week.

• Term Stillbirth: The fetus dies after the 36th week of term stillbirth.

What Is the Prevalence Rate of Stillbirth?

In the United States, out of every 160 births, one birth is stillbirth, and it accounts for about 24,000 babies.

What Is the Cause of Stillbirth?

The cause of stillbirth is significant not only for the medical professional but also for consoling the grieving family. Although the cause of stillbirth is not known in most cases, the following have been attributed to be the causative factors:

• Lupus:

The risk of stillbirth is increased in gestating mothers who have lupus.

• Preeclampsia:

The risk of stillbirth or placental rupture is twice increased in people who have preeclampsia. Preeclampsia is a condition in which there is increased blood pressure.

• Clotting Disorders:

If the mother has a clotting disorder such as hemophilia, the risk of developing stillbirth is high.

• Placental and Umbilical Cord Problems:

The fetus gets its blood supply, nutrients, and oxygen from the placenta and umbilical cord. During pregnancy, the placenta lines along with the uterus. The risk of stillbirth is increased in people who have problems associated with the placenta or umbilical cord.

• Congenital Defects:

Congenital disabilities in children contribute to about one-fourth of stillbirths.

• Lifestyle Habits:

The lifestyle habits of the mother have a significant influence on the developing fetus. Habits like smoking, drinking alcohol, and using recreational drugs increase the risk of developing stillbirth.

• Trauma:

Traumatic accidents like car crashes can cause the development of stillbirth.

• Infection:

Any kind of infection of the uterus can cause stillbirth between the 24th and 27th week. These infections travel from the vagina to the uterus. Common bacterial infections include Escherichia coli, Group B Streptococcus, Chlamydia, Mycoplasma, Enterococcus, Klebsiella, Ureaplasma, and Haemophilus influenzae. In addition, other infections like malaria, Lyme disease, flu, rubella, herpes, etc., can also cause stillbirth.

• Intrahepatic Cholestasis of Pregnancy:

The risk of stillbirth is increased in people who have obstetric cholestasis or intrahepatic cholestasis of pregnancy, a liver disorder associated with itching.

How Is a Stillbirth Manifested?

There are no early symptoms. Abdominal cramps, pain, vaginal bleeding, and stopped baby movements are a few of the signs of stillbirth. Between the 26th and 28th week of pregnancy, daily kick count can be noted. Every baby is different, and therefore, the number of times the baby moves is different for each baby. Count the number of kicks, rolls, and flutters by lying on the left side and note it every day at the same time. Within two hours, if you notice a lot less movement or if your baby has not moved ten times, then contact your healthcare professional.

After a stillbirth, if a mother experiences signs like fever, chills, bleeding, and pain, it is a sign of infection that needs medical intervention.

Does Lactation Occur After a Stillbirth?

Once the placenta is delivered, lactation is enabled by the production of milk-producing hormones. Lactation can be let to stop naturally. It can also be stopped by taking Dopamine agonists when there is no preeclampsia.

Can Stillbirth Cause Infertility?

Having a stillbirth does not mean there are fertility problems, or you will experience one in the future.

How Is Stillbirth Diagnosed?

Reduced or no baby movements is an essential diagnostic feature of stillbirth. However, an ultrasound can be taken to confirm it.

The cause of stillbirth can be identified with the help of the following tests:

• Blood tests to check for preeclampsia, diabetes, or obstetric cholestasis.

• The presence of infection can be identified by taking blood tests, urine tests, or culture tests from the vaginal or cervical cells.

• The umbilical cord, placenta, and membranes should be checked for any abnormalities.

• Thyroid gland disorders can be diagnosed with the help of thyroid function tests.

• Genetic testing to check for genetic disorders like Down’s syndrome can be done by taking umbilical cord samples from the fetus.

Doing an autopsy is the right of the parent while doing it for legal reasons is needed in the following situations:

• Death of the baby within 24 hours of surgical operation.

• The sudden death of the baby.

• The cause of death cannot be certified by the medical professional.

How Is the Stillborn Baby Delivered?

The stillborn baby is delivered in one of the following methods:

1. Natural Birth: Although natural birth can be tried in some cases, deterioration of the child may happen in the womb when it takes time.

2. Induced Labor: It is the best option for delivering a stillborn baby and is suggested immediately when the mother has severe preeclampsia, clotting disorder, broken water bag, or a severe infection.

Induced labor is done by either of the following:

1. Vaginal suppository.

2. Oral tablet.

3. The gel is applied over the vagina.

4. A vein drip.

5. Foley bulb.

3. Cesarean Section: It is not reliable as natural birth and induced labor and hence is not recommended in most cases.

How Can Stillbirth Be Prevented?

A stillbirth occurs when the development of the baby is not regular or adequate. Therefore, stillbirth can be prevented by:

• Improving the mother’s health.

• Managing pre-existing conditions.

• Improving the lifestyle choices of the mother.

• When there is an increased risk, then fetal heart rate monitoring and ultrasound scan can be monitored routinely to deliver the baby earlier if a problem arises.

What Should a Mother Do to Prevent stillbirth?

• Avoid smoking, recreational drugs, and alcohol.

• Familiarizing the daily baby counts to look out for any abnormality when there is a change in the fetal movements.

• Bleeding during the second half of the gestation period should be intervened by a medical professional.

• Sleep on the side rather than on your back.

• Avoid foods like cheese and some fish.

• Do not take foods that are not cooked properly.

• Vaginal bleeding, itching, and pain should be checked immediately.

• Blood pressure and urine should be checked regularly.

Is Pregnancy Possible After a Stillbirth?

The chance of consequent stillbirth is about 3%. Stillbirth caused by a pre-existing health condition of the mother has a higher chance of recurrence. If stillbirth is caused by placental or umbilical cord problems, the possibility of subsequent stillbirth is slight. However, normal pregnancy and birth can occur after a stillbirth.

How Can I Cope Up After a Stillbirth?

Take time to heal yourself mentally and physically. Have you made any plans for your baby? Such as his or her nursery, still, cherish those moments. Do not be pessimistic about the loss.

Accept the loss and do not blame yourself for the same. People might advise you to forget, but there is no necessity that you should. It is still your baby; honor your unborn child; the baby will still be a member of the family, one among you.

Whatever the pregnancy stage, the loss has occurred, it is entirely normal to experience post-traumatic stress disorder and depression. Have a heart out with people you can trust, be it your partner, parents, or friends. Also, talking with mothers who had a similar experience can give you an insight into how you can face this phase boldly. Do not be stressed over a slip, as you can still have better things coming.

Conclusion

Stillbirth can be devastating, but still, you have to come out of this. If needed, seek the help of mental health professionals. It is essential to be in touch with your healthcare provider during and after pregnancy. Do not be worried because a normal pregnancy is possible even after a stillbirth.