The Main Causes and Risk Factors of Stillbirth

The causes of stillbirth depend on the gestational age and underlying risk factors. Placenta or umbilical cord issues and congenital disabilities lead to improper development of the fetus. In addition, chromosomal abnormalities associated with congenital disabilities increase the risk of stillbirth.

Placental abruption refers to the placenta separating suddenly from the uterus wall during pregnancy while the fetus stays in the womb. It occurs due to unhealthy conditions of pregnant women or structural abnormalities in the uterus.

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Intrauterine growth restriction is a condition that leads to the low weight of the fetus for the number of pregnancy weeks. Severe cases of intrauterine growth restriction cause stillbirth or increase the risk of losing the newborn.

Preeclampsia or high blood pressure and swelling increase the risk of late pregnancy, leading to placental abruption or stillbirth.

Blood clotting disorders like hemophilia and illnesses like diabetes, heart disease, thyroid disease, or infections increase the risk of stillbirth.

Obstetric cholestasis, which is a liver disorder, can cause severe itching.

Infection between 24^{\text{th}}24
and 27^{\text{th}}27
week can cause fetal death. Usually, the bacterial infection travels from the vagina to the fetus.

Infections occur due to group B streptococcus, Escherichia coli, influenza, mycoplasma, and enterococcus. In addition, infections like sexually transmitted diseases, rubella, and malaria contribute to 13\%13% of stillbirth.

Trauma like accidental falling or vehicle accidents can cause stillbirth. Umbilical cord accidents during pregnancy include a tight knot in the cord or the cord wrapping the baby’s neck.

Diagnosis and Management of Stillbirths
The physical symptoms that pregnant women can have include fever, vaginal bleeding, and pain. The typical symptom of stillbirth is no fetal heartbeat when the health care provider uses a stethoscope or Doppler. Ultrasound confirms whether the baby is alive or not. Diagnosis for confirming the causes of stillbirth includes blood tests, thyroid function tests, genetic tests, and examinations of the umbilical cord and placenta.

Other examinations are Rh grouping, postprandial blood sugar, urea, creatinine, lupus anticoagulant, anticardiolipin antibodies, and thrombophilia studies. Urine examination includes cast and pus cells.

Blood test confirms preeclampsia, obstetric cholestasis, or diabetic causes.

Amniocentesis test provides information to find the genetic or infection cause of stillbirths.

Examination of the umbilical cord and placenta attached to the fetus indicates an abnormality that the baby is prevented from receiving oxygen, blood, and nutrients.

A sample of the umbilical cord is necessary to determine the genetic causes. With the mother’s consent, an autopsy of the baby is essential to determine the cause of the stillbirth.

Management: Dilation and evacuation procedure dilates the cervix to remove the tissue from the uterus lining. This procedure can limit the information that the healthcare provider can get about the baby’s condition.

Induced labor is the best option for stillbirth. Natural birth is the other option, but it can deteriorate the baby’s body in the womb. Deterioration may also cause difficulty in determining the cause of the baby’s death.

Cesarean section is usually not recommended, and it is not as safe as natural birth or induced labor.

Prevention of Stillbirth
A stillbirth occurs due to abnormal development of the fetus. Managing the mother’s health, like managing a pre-existing health issue and good lifestyle choices, improve the chances of a successful pregnancy.

Women should avoid recreational drugs consumption, smoking, and drinking alcohol during pregnancy.

Pregnant women must contact the health care provider while they get vaginal bleeding during pregnancy.

Pregnant women can count the daily kick count of the baby movements during the 26 to 28 weeks. If they find the kick count in a day is decreasing or stopping, they must contact the health care provider.

Protection against infections and reporting health issues like stomach pain and itching to the healthcare provider are essential preventive measures.

Sleeping on the back can be risky for pregnant women after 28 weeks, which increases the risk of stillbirth. In addition, it can affect the blood flow and oxygen supply to the baby.

Routine tests like blood pressure and urine tests are essential to find illnesses or other conditions that affect the baby’s health.

During pregnancy, foods to be avoided are mold-ripened cheese, liver foods, raw and cooked meat, unpasteurized milk, raw shellfishes, and caffeine drinks.

Causes such as congenital disability or umbilical cord issues lead to stillbirth. If the causes include illness of the mother or genetic disorder, then the chances of stillbirth are higher.

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