When fetal death occurs after 20 weeks of pregnancy, it is called stillbirth. These tragic deaths occur in about 1 in 160 pregnancies. Most stillbirths occur before labor begins. The pregnant woman may suspect that something is wrong if the fetus suddenly stops moving around and kicking. A small number of stillbirths occur during labor and delivery.
How is fetal death diagnosed?
An ultrasound examination (a test that uses sound waves to take a picture of the fetus) can confirm that the fetus has died by showing that the fetus’s heart has stopped beating. It sometimes can help explain why the fetus died. The health care provider also can do some blood tests on the woman to help determine why the fetus died.
How is the pregnant woman treated?
The health care provider discusses options for delivering the fetus. Some women may need to deliver immediately for medical reasons. However, many couples can decide when they want to deliver the fetus. Some choose to wait until the woman goes into labor. Labor usually starts within two weeks after the fetus dies. Waiting for labor generally poses little risk to a woman’s health. If labor has not begun after two weeks, providers recommend inducing labor because there is a small risk of developing dangerous blood clots after this time.
Most couples choose to have labor induced soon after they learn of their baby’s death. If the woman’s cervix has not begun to dilate in preparation for labor, the provider may use vaginal medicine to help prepare her cervix. She is then treated with the hormone oxytocin (also called Pitocin), which is given through a vein. Oxytocin stimulates uterine contractions. Generally, a woman does not need a cesarean unless she develops problems with labor and delivery.
What tests are done after the fetus is delivered?
After delivery, the fetus, placenta and umbilical cord are examined carefully to help determine why the fetus died. The provider often recommends an autopsy and tests to diagnose common chromosomal problems. In some cases, the provider recommends tests for specific disorders or various infections.
In up to half of all cases, these tests cannot determine the cause of stillbirth. However, information from these tests often is useful in helping couples plan a future pregnancy, even if the cause of the stillbirth remains unknown.
What are the causes of stillbirth?
There are a number of known causes of stillbirth. Sometimes more than one of these causes may contribute to the baby’s death. Common causes include:
INFO ON NEONATAL LOSS
Neonatal loss is when a baby dies in the first 28 days of life.
The most common cause of neonatal death is premature birth. About 25% of premature birth complications result in neonatal death. 20% of neonatal loss is caused from birth defects. Other causes are lack of oxygen to the brain during birth, infections, and complications involving the placenta and umbilical cord.
High blood pressure, pregnancy complications, lifestyle factors like smoking, and other health problems put women at risk of delivering prematurely. Serious complications such as respiratory distress syndrome, intraventricular hemorrhage, necrotizing entercolitis, and infections cause neonatal death.
Respiratory distress syndrome is when a baby's lungs are immature and lack a protein called surfactant that keeps small air sacs in the lungs from collapsing. Necrotizing enterocolitis is an intestinal problem that causes a serious inflammation of the bowel. Intraventricular hemorrhage is bleeding in the brain. There are also some birth defects that cause neonatal death like heart defects, lung defects, chromosomal abnormalities, and brain and central nervous system defects.
For more information go to http://www.marchofdimes.com/baby/loss_neonataldeath.html
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