Definition

Stillbirth is the death of a fetus after 20 weeks of pregnancy. It often happens before labor begins.

Causes

Stillbirth may be caused by:

• Problems in the fetus such as:
  • Chromosomal disorders
  • Poor growth
• Problems from having more than one fetus
• Health conditions in the mother
• Rh incompatibility
• Umbilical cord problems, such as:
  • Umbilical cord prolapse
  • A loop or knot in the cord
• Problems with the placenta, such as:
  • Placental abruption
  • Placenta previa

In many cases, the cause is unknown.

Risk Factors

Stillbirth is more common for women aged 35 years and older. Other things that raise the risk are:

• Mother has health problems, such as:
  • Obesity
  • Diabetes
  • Autoimmune diseases such as lupus
  • High blood pressure
  • Diseases of the thyroid , kidney, or heart
  • Blood clotting disorder
  • Epilepsy
  • Asthma
• Infection
• Smoking, drinking, or using drugs during pregnancy
• Poor prenatal care
• History of stillbirth or miscarriage
• More than one fetus
• First pregnancy
• Trauma, such as a car accident

Symptoms

Symptoms are:

• No movement by the fetus
• Vaginal bleeding in the mother

Diagnosis

An ultrasound exam may be done. The doctor will examine the baby and look for a heartbeat.

The ultrasound may show the cause of the stillbirth. After birth, other tests may be done to understand the cause.

Abdominal Ultrasound Copyright © Nucleus Medical Media, Inc.

Treatment

The fetus will need to be delivered. A vaginal birth is the safest option for most. Some may need a cesarean section. The doctor will talk about options.

Labor may be started with medicine. It may be given through the vagina, as pills, or by IV. Treatment may not be needed if there are other living fetuses.

Prevention

Not all stillbirths can be prevented. The risk may be lowered by:

• Going to all prenatal visits
• Reaching and keeping a healthy weight
• Taking prenatal supplements such as:
  • Folic acid
  • Iron, if needed
• Not drinking, smoking, or using drugs during pregnancy