What are the causes of stillbirth?
Although there are several known causes of stillbirth, unfortunately most remain a mystery. They could be down to a single factor or to a combination of several.
For those stillbirths that are explained the following causes are often pinpointed:
Premature babies are at risk of stillbirth as they may not be physically able to endure labor.
Some infections have been shown to be dangerous to unborn babies. These include listeria, salmonella, syphilis, toxoplasmosis and rubella. Infections such as these can cause physical deformities or stillbirth if undiagnosed or untreated.
Some lifestyle choices can put babies at risk of stillbirth. These include taking excess alcohol, smoking or using certain drugs, illegal or prescribed, during pregnancy.
Disorders of the Immune System
Stillbirth can sometimes be caused by disorders of the immune system. Anti-phospholipid syndrome (APS) is one such disorder which causes the immune system to interfere with normal blood clotting. As a result the placenta can stop functioning properly meaning the baby fails to receive vital nutrients and oxygen.
When a mother-to-be has a Rhesus (Rh) negative blood group and her baby's is Rhesus positive, she may develop antibodies to her baby. Normally her first baby will be born safely and without any resulting complications. However, because the antibodies may remain in her blood, future babies will be at risk as her body may reject them, causing them to be stillborn. For this reason, mothers with Rh negative blood groups are usually given medication in future pregnancies to prevent complications.
Pre-existing maternal medical conditions
In some instances stillbirth can be caused by pre-existing maternal medical conditions. If you are thinking about trying for a baby you should be aware of the risks any medical conditions from which you suffer may cause and seek advice before becoming pregnant. It is also vital to inform your doctor and midwife if you suffer from any pre-existing maternal medical conditions in order for them to keep a closer eye on you throughout your pregnancy.
Pre-eclampsia is a serious problem associated with rising blood pressure during pregnancy and nowadays mothers are routinely screened for the signs of pre-eclampsia. If it is not detected or treated in time it can be life-threatening to both mother and baby. Every year around 1000 babies in the UK die becuse of pre-eclampsia - many of them are stillborn.
Obstetric cholestasis is a liver disease of pregnancy causing severe itching all over the mother-to-be's body. The liver's normal funtioning is affected allowing potentially harmful toxins to build up. This can lead to stillbirth if untreated and may be responsible for 5% of all unexplained UK stillbirths. If you suffer from unexplained itching during pregnancy it is very important to mention it to your doctor.
A congenital malformation means the baby had a genetic or physical defect which happened during development leading to the death of the baby. This accounts for around 12% of stillbirths.
Whilst the majority of stillbirths occur before labor, sometimes stillbirth can happen as a result of trauma suffered by the baby during labor. If the baby suffers a reduction in oxygen supply as a result of a prolonged labor, for example during a breech delivery, shoulder dystocia or because the umbilical cord is wrapped tightly around the baby's neck, then stillbirth can result.
During a normal pregnancy the placenta remains in place until after the baby is delivered. However, if the placenta comes away from the womb lining prematurely, ante-partum haemorrhaging can occur. It can also happen if the mother is suffering from placenta previa, ie when the placenta is covering the opening of the womb, or if the placenta is lying low in the womb causing the placenta to break away as the cervix dilates and as a result the baby's blood supply is cut off. If a mother-to-be suffers bleeding during her pregnancy she should get immediate help as bleeding can be an indication one of the above is occuring. More than 16% of stillbirths are accounted for because of ante-partum haemorrhaging.
How can I find out the causes of stillbirth?
If your baby is stillborn a blood test may be taken to look for chromosomal abnormalities and the placenta and umbilical cord will be examined for abnormalities. An autopsy may also be performed to try to determine the cause. In some instances you can decide not to have an autopsy carried out if you are uncomfortable with it, or you can ask for certain instructions to be followed. For example you may not wish for incisions to be visible on certain parts of the baby.
However, sometimes an autopsy is legally required. This includes when:
A baby has died within 24 hours of a surgical operation
A doctor cannot certify the cause of death
A baby has lived (defined as "drawing breath") and died suddenly
Further Information on StillBirth
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