Stillbirth

A stillbirth occurs when a fetus, of mid-second trimesterto full termgestational age, which has diedin the wombor during labouror delivery, exits the maternalbody.

Human stillbirth

Causes

A large percentage of humanstillbirths are of unknown causes, even in cases where extensive testing and autopsyhave been performed. Some of the causes that have been found are:

• bacterial infection
• birth defects
• chromosomal aberrations
• growth retardation
• maternal diabetesor high blood pressure
• maternal consumption of nicotene, alcohol, recreational drugs(excluding cannabis), or pharmacuetical drugscontraindicatedin pregnancy
• postmaturity
• placental abruption
• physical trauma
• Rh disease
• umbilical cord accidents

Prenatal diagnosis

A decrease or cease of fetal activitymay be an indication of fetal distressor death, though it is not entirely uncommon for a healthy fetus to exhibit such changes, particularly near the end of a pregnancywhen there is considerably little space in the wombfor the fetus to move about. Still, medical examinationis recommended in the event of any change in the strength or frequencyof fetal movement, especially a complete cease, and most midwivesand obstetriciansrecommend the use of a kick chartto assist in detecting any changes. Fetal distress or death can be confirmed or negated via fetoscope/doptone, ultrasound, and/or electronic fetal monitering.

Prenatal maternal treatment

An in uterofetal death does not present an immediate health risk to the mother and labour will usually begin spontaneouslyafter two weeks, so the mother may choose to wait and deliver the child naturally. After two weeks, the mother is at risk of developing bloodclottingproblems, and inductionis recommended at this point. In many cases, the mother will find the idea of carrying a dead fetus emotionally traumatizingand will elect to be induced. Cesareandelivery is not recommended unless complications develop during vaginal birth.

Impact on family

As with any lossor traumatic event, particularly those involving one's offspring, a grieving periodis to be expected; the mother often experiences a heightened sense of grief after a stillbirth, due to her close proximity to the child at the time of death. Grief reactions can range from normal depression, including misplaced guiltand/or blame, to psychosis, such as experiencing phantom fetal movement or newborn crying, inability to face taking down a nursery, "replacement child syndrome" in which the next child is saddled with the expectations of the "ideal" first child, or "vulnerablechild syndrome" in which all subsequent children are seen as fragileand prone to harm or illness.

Everyone responds differently to grief and loss: some individuals cope better with their grief if presented with the option of spending some personal moments with their child, and many parents wish to keep memorabiliasuch as clothing, hospitalbracelets, and/or footprints/ultrasound photos; often, missing these opportunities (due to shock, illness, or other factor) or being denied them can compound the loss, and it is important that these options be expressly offered or suggested by the health careproviders or others involved with the family.

Many families also require assistance and/or options in regard to:

• Early hospital arrangements
• Funeralplans
• Crisisintervention, grief counselling, and referral to other support serices

See also

Childbirth

• Live birth
• Perinatal death
  • Intrapartum death
  • Neonatal death
    • Sudden infant death syndrome
• Abortion
  • Elective abortion
    • Anomalous pregnancy
      • Ectopic pregnancy
      • Molar pregnancy
  • Spontaneous abortion
• Maternal death

References

External links

• March of Dimes: Quick reference and fact sheet
• Investigating perinatal death: a review of the options when autopsy consent is refused.

de:Totgeburt

This article is licensed under the GNU Free Documentation License.
It uses material from the Wikipedia article Stillbirth.