Everything about Stillbirth totally explained
A
stillbirth, meaning "quiet birth" occurs when a
fetus which has
died in the
uterus or during
labor or
delivery exits a
woman's
body. The term is often used in distinction to
live birth or
miscarriage. Most stillbirths occur in full term pregnancies.
Some sources reserve the term "stillbirth" for a fetus which has died after reaching mid-
second trimester to
full term gestational age. For example, in the United Kingdom, "stillbirth" is used to describe an infant delivered without life after 24 weeks gestation. The sources that use this definition tend to use the term "miscarriage" if the death occurs earlier in development. In contrast, other sources use the term "stillbirth" regardless of the stage of fetal development.
Human stillbirth
Causes
The causes of a large percentage of
human stillbirths remain unknown, even in cases where extensive testing and
autopsy have been performed. The term used to describe these is
sudden antenatal death syndrome or SADS. In cases where the cause is known, some possibilities of the cause of death are:
Prenatal diagnosis
A decrease or cessation of
fetal activity may be an indication of
fetal distress or death, though it isn't entirely uncommon for a healthy fetus to exhibit such changes, particularly near the end of a
pregnancy when there's considerably little space in the
uterus for the fetus to move about. Still,
medical examination, including a
nonstress test, is recommended in the event of any change in the strength or
frequency of fetal movement, especially a complete cease; most
midwives and
obstetricians recommend the use of a
kick chart to assist in detecting any changes. Fetal distress or death can be confirmed or ruled out via
fetoscopy/
doptone,
ultrasound, and/or
electronic fetal monitoring. If the fetus is alive but inactive, extra attention will be given to the
placenta and
umbilical cord during ultrasound examination to ensure that there's no compromise of oxygen and nutrient delivery.
Prenatal maternal treatment
An
in utero fetal death doesn't present an immediate health risk to the woman and labour will usually begin
spontaneously after two weeks, so the woman may choose to wait and deliver
vaginally. After two weeks, the woman is at risk of developing
blood clotting problems, and
induction is recommended at this point. In many cases, the woman will find the idea of carrying a dead fetus
emotionally traumatizing and will elect to be induced.
Cesarean delivery isn't recommended unless complications develop during
vaginal birth.
Prevalence
Stillbirth is a relatively common, but often random, occurrence. The
mean stillbirth
rate in the
United States is approximately 1 in 115 births, which is roughly 26,000 stillbirths each
year, or on an average one every 20
minutes. In
Australia,
England,
Wales, and
Northern Ireland, the rate is approximately 1 in every 200 births, in
Scotland 1 in 167. (From The National Statistical Office and other sources.)
In
developing countries, where
medical care can be of low quality or unavailable, the stillbirth rate is much higher.
Legal definitions of stillbirth
Australia
In
Australia any stillborn fetus weighing more than 400 grams, or more than 20 weeks in gestation, must have its birth registered.
Canada
Beginning in 1959, "the definition of a stillbirth was revised to conform, in substance, to the definition of fetal death recommended by the
World Health Organization." The definition of "fetal death" promulgated by the
World Health Organization in 1950 is as follows:
» "Fetal death" means death prior to the complete expulsion or extraction from its mother of a product of human conception, irrespective of the duration of pregnancy and which isn't an induced termination of pregnancy. The death is indicated by the fact that after such expulsion or extraction, the fetus doesn't breathe or show any other evidence of life, such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles. Heartbeats are to be distinguished from transient cardiac contractions; respirations are to be distinguished from fleeting respiratory efforts or gasps. In
England and Wales, this must be done within 42 days and a Stillbirth
Certificate is issued to the parent(s). In
Scotland, this must be done within 21 days.
United States
In the
United States, there's no standard definition of the term 'stillbirth'.
The
Centers for Disease Control and Prevention collects statistical information on "live births, fetal deaths, and induced termination of pregnancy" from 57 reporting areas in the United States. Each reporting area has different guidelines and definitions for what is being reported; many don't use the term "stillbirth" at all. The federal guidelines suggests (at page 1) that fetal death and stillbirth can be interchangeable terms. The CDC definition of "fetal death" is based on the definition promulgated by the World Health Organization in 1950 (see
section above on Canada).
The federal guidelines recommend reporting those fetal deaths whose birth weight is over 350g, or those over 19 weeks gestation. Forty-one areas use a definition very similar to the federal definition, thirteen areas use a shortened definition of fetal death, and three areas have no formal definition of fetal death. Only 11 areas specifically use the term 'stillbirth', often synonymously with fetal death, however they're split between whether stillbirths are "irrespective of the duration of pregnancy", or whether some age or weight constraint is applied.
Further Information
Get more info on 'Stillbirth'.
|
External Link Exchanges
Do you know how hard it is to get a link from a large encyclopaedia? Well we're different and will prove it. To get a link from us just add the following HTML to your site on a relevant page:
<a href="http://stillbirth.totallyexplained.com">Stillbirth Totally Explained</a>
Then simply click through this link from your web page. Our crawlers will verify your link, extract the title of your web page and instantly add a link back to it. If you like you can remove the words Totally Explained and embed the link in article text.
As long as your link remains in place, we'll keep our link to you right here. Please play fair - our crawlers are watching. Your site must be closely related to this one's topic. Any kind of spamming, dubious practises or removing the link will result in your link from us being dropped and, potentially, your whole site being banned. |
