The death of the fetus in the early or late months of pregnancy is obviously the most difficult test for every woman. Miscarriage which is a loss of the fetus before the twenty-fourth week of pregnancy, of course, is also very hard. But the loss of a fully formed child during or after delivery seems to be the most terrible outcome of pregnancy. This article may probably seem hard to read. Nevertheless, many women who survived such a tragic event often express regret that they were not aware of what causes stillbirth. So, in this article, we will talk about some of the causes of stillbirth.
What Is Stillbirth?
In this case, we are talking about the birth of a dead child after the 20th week of pregnancy. The loss of the fetus before the 20th week is called a miscarriage. The statistics show that 1 of 200 pregnancies results in stillbirth. Since the signs of stillbirth are not obvious, the couple is often not ready for such a terrible event.
Most women whose fetus is born dead can later bear and give birth to a healthy child. If the birth of a dead fetus was caused by chromosomal abnormalities or umbilical cord disorders the chances of another stillbirth are small. If the cause is a chronic or genetic disease the risk slightly increases. In general, the chances of having a healthy baby in future are more than 90%.
What Should You Be Careful About?
The first warning signal is the reduction or complete cessation of fetal movements in the uterus. Along with this, bleeding from the vagina can begin. If you notice these signs, consult a doctor immediately. You will be assigned an ultrasound or test of the heartbeat of the fetus.
Sometimes the first sign of the problem is premature birth which begins with the bursting of the waters and dilating pains.
Is It Possible to Find Out What Caused Stillbirth?
The cause of death can be detected by analyzing the mother’s blood, examining the placenta, or performing an autopsy of the child’s body. But the thing is that it’s impossible to find the explanation in more than half of the cases.
An autopsy will help:
- To establish the causes of death,
- Receive information about the development of the child,
- Get information about health problems that need to be taken into account during the subsequent pregnancy,
- Determine the sex of the child.
An autopsy does not always reveal the cause of death which badly influences the parents. You can disagree on an autopsy by personal, religious, or other beliefs. The hospital staff must provide you with all the information on this topic so that you can make a decision. Without your consent, no studies will be conducted. Your wishes should be taken into account. Perhaps you need time to think things over, that’s absolutely fine. But the earlier the autopsy is performed the more information you can get.
If you decide to allow an autopsy you must declare your consent before the procedure. You will know in advance whether you can see the child after the autopsy and how the baby will look. If the baby is not shown after the autopsy it is probably better to say goodbye before the procedure. When you are informed about the results, discuss them with your doctor.
What Causes Stillbirth? Possible Reasons
In more than half of the cases, the cause of death cannot be established. But there are some factors that can lead to unfortunate consequences:
- Genetic or physical abnormalities when the brain, heart or other organs of the fetus do not develop properly.
- Bleeding before the delivery, for example, because of the premature abruption of the normally located placenta.
- Prematurity – the baby may not survive childbirth. Sometimes this is due to placental insufficiency when the fetus receives little oxygen and nutrients.
- Preeclampsia or late toxicosis of pregnant women. About 1000 children die every year from preeclampsia. Most of them are born dead.
- Rhesus incompatibility when antibodies in the mother’s blood attack blood cells of the fetus.
- Cholestasis of pregnancy. This is a rare complication of pregnancy when there is an increase of bile acid in the bloodstream. The risk of stillbirth with this disease is 15% higher than in the absence of complications.
- Infections such as listeriosis, salmonellosis, or toxoplasmosis.
- Diseases of the immune system – for example, Anti-Phospholipid Syndrome.
What Causes Stillbirth? Other Reasons
- Poor growth of the fetus – children who grow slowly have a significantly increased risk of being born dead, especially those whose growth is far less than normal.
- Placental abruption – the placenta begins to separate from the uterus before the baby is born. This is another cause of stillbirth.
- Congenital defects – genetic and chromosomal abnormalities as well as structural defects can lead to stillbirth. Some stillborn babies have several birth defects.
- Infections – infectious diseases of the placenta, the baby, or the mother cause stillbirth, especially when the baby dies before the 27th week of pregnancy. Infections lead to the development of infectious erythema (parvovirus B19), CMV (cytomegalovirus), listeriosis, and syphilis which cause the death of the child.
- Problems with the umbilical cord. Accidents associated with the umbilical cord also lead to a small number of stillbirths. When the umbilical cord wraps around the baby’s neck, or if the umbilical cord is not connected to the placenta properly the child may be deprived of oxygen. Problems with the umbilical cord are common in healthy children but they are rarely the main cause of the birth of a dead fetus.
- Other causes of stillbirth, such as hypoxia (lack of oxygen) during difficult, prolonged labor or abdominal trauma (for example, due to a car accident), can also cause stillbirth.
- Many children die because of a birth trauma. The risk increases with the dystocia of the shoulders: during the delivery, the shoulders get stuck and cannot get through the birth canal. Also, the risk increases with the breech presentation of the fetus. Problems with the umbilical cord can lead to acute fetal hypoxia which causes stillbirth.
One-third of all fetal deaths occur after a full-term pregnancy. Multifetal pregnancy is at greater risk (1.5-1.6%) than singleton one (0.5-0.6%).
Who Are in the Stillbirth Risk Group?
Such a misfortune can happen to any pregnant woman but some future mothers are at a greater risk than others. The probability that pregnancy will end in stillbirth is much higher if the expectant mother:
- Has had problems with the previous pregnancy or has complications with the current pregnancy, such as gestational hypertension (caused by pregnancy), preeclampsia, eclampsia, or cholestasis (liver disease).
- Has a premature birth in her medical history.
- Suffers from chronic health problems such as hypertension, lupus, kidney and urinary tract diseases, diabetes mellitus, thrombophilia (blood clotting disorder), or thyroid disorders.
- Smokes, drinks alcohol, or takes drugs during pregnancy.
- Carries twins or more children.
- Suffers from obesity.
- The age of both the future mother and the future father also affects the risk of stillbirth. The teenagers younger than 15 and women after 40 years of age and older belong to the risk group.
After the Tragedy
If a child has died for unknown reasons it doesn’t increase the risk of stillbirth in future.
If there was a congenital malformation you’d better have a genetic examination.
Some factors can lead to the birth of a dead fetus. For example, smoking during pregnancy increases the risk. You should take precautions to avoid infection with listeriosis, salmonellosis, and toxoplasmosis during pregnancy. Maintain a healthy lifestyle and follow all the doctor’s recommendations. If pain or bleeding occurs, seek medical help immediately.
After experiencing such a tragedy, a lot of women try to get pregnant again as soon as possible. Others, on the contrary, have doubts about getting pregnant with another child. In any case, the next pregnancy can be very unsettling for a woman.
Some women want to return to the same hospital, to the same staff. Others prefer to forget about the sad experience and give birth in another place. There are perinatal centers that provide support to parents who have lost a child in the past. If you can’t overcome the tragedy, don’t be afraid to ask for help.