Stillbirth Flashcards
(11 cards)
What is stillbirth?
The birth of a dead fetus after 24 weeks gestation as the result of intrauterine fetal death.
What are the causes of stillbirth?
Unexplained, pre-eclampsia, placental abruption or vasa praevia, cord prolapse, diabetes & thyroid disease, obstetric cholestasis, infections eg. rubella, parvovirus, listeria, genetic abnormalities or congenital malformations
What are the risk factors for stillbirth?
Fetal growth restriction, smoking & alcohol, increased maternal age, sleeping on back, maternal obesity, twins
How is prevention of stillbirth done?
Risk assessments for babies who are SGA or with FGA. those at risk have fetal growth closely monitored with serial growth scans
- Women at risk of pre-eclampsia are given aspirin and modifiable risk factors treated.
What are the three key symptoms to always ask during pregnancy?
- Reduced fetal movements
- Abdominal pain
- Vaginal bleeding
What diagnosis is done to confirm fetal viability?
USS to visualise fetal heartbeat to confirm whether or not fetus is alive. Passive fetal movements are possible after IUFD and a repeat scan is offered to confirm the situation.
What do rhesus D negative women require and what test is done?
Anti-D prophylaxis. Kleihauer test is used to quantify how much fetal blood is mixed with the maternal blood to determine the dose of anti-D that’s required.
What birth method is first line for stillbirth?
Vaginal unless there are other reasons for C section. Women are given a choice of induction of labour or expectant management (awaiting natural labour and delivery - need close monitoring).
How do you induce labour?
Combination of oral mifepristone (anti-progesterone) and vaginal or oral misoprostol (prostaglandin analogue).
What is used to suppress lactation after stillbirth?
Dopamine agonists e.g. cabergoline.
What testing is carried out after stillbirth to determine the cause?
Genetic testing, postmortem examination of fetus, testing for maternal and fetal infection, testing mother for conditions associated with stillbirth such as diabetes, thyroid disease & thrombophilia.
