Flashcards in STILLBIRTH Deck (9)
What is the definition of a stillbirth?
A baby that is born with no signs of life after 24 weeks of gestation.
What is the incidence of stillbirth?
1 in 200 pregnancies
How is intrauterine death most often diagnosed?
Reduced fetal movement leading to ultrasound scan, looking for heart beat.
What are the maternal causes of stillbirth (as opposed to fetal or placental)?
Acute fatty liver
Thrombophilia eg protein C and protein S resistance, factor V Leiden, antithrombin III deficiency
What are fetal causes of stillbirth (as opposed to maternal or placental)?
Infection: toxoplasma, listeria, syphilis, parvovirus
Twin-to-twin transfusion syndrome
What are the placental causes of stillbirth (as opposed to maternal or fetal)?
Praevia: significant bleed
In what proportion of cases of stillbirth will no cause be found?
What investigations would you do to look for a cause of stillbirth?
FBC - haemorrhage, WCC, platelets
CRP - infection
U+Es - pre-eclampsia, haemorrhage
LFTs - obstetric cholestasis, haemorrhage, sepsis, pre-eclampsia
Coagulation screen - VTE
Kleihauer - Rh-ve, also estimate fetomaternal haemorrhage,
Maternal thrombophilia screen - VTE
Parental karyotyping - if fetal karyotyping indicates unbalanced translocation
Urine dip/MSU - infection
Cultures and serology - infection