Symptoms
Stillbirth itself doesn't present with symptoms for the mother. However, the following may indicate a potential problem requiring immediate medical attention, which, if left unaddressed, *could* lead to stillbirth:
Decreased fetal movement: A noticeable reduction or absence of fetal movement as perceived by the mother.
Vaginal bleeding: Any bleeding during the later stages of pregnancy.
Abdominal pain or cramping: Persistent or severe abdominal pain.
Absence of fetal heartbeat: If the mother has a fetal Doppler monitor at home and cannot detect a heartbeat.
Sudden decrease in pregnancy symptoms: A sudden and unexplained lessening of typical pregnancy symptoms.
Causes
Many stillbirths occur without a definitive, identifiable cause. However, some known or suspected causes include:
Placental problems: Issues with the placenta, such as placental abruption (separation of the placenta from the uterine wall) or placental insufficiency (the placenta not providing enough oxygen and nutrients to the fetus).
Fetal growth restriction (FGR): The fetus is not growing at the expected rate.
Birth defects: Congenital anomalies or genetic conditions.
Infections: Maternal infections, such as listeriosis, cytomegalovirus (CMV), or parvovirus B19.
Umbilical cord problems: Issues like cord prolapse (the cord comes out before the baby), cord compression, or a true knot in the cord.
Maternal health conditions: Conditions such as pre-eclampsia, gestational diabetes, lupus, or chronic hypertension.
Rh disease: An incompatibility between the mother's and baby's blood types that may lead to fetal anemia.
Multiple Gestation: Having twins, triplets, or more.
Medicine Used
There is no medication used to "treat" stillbirth itself. However, medications may be used to manage underlying maternal conditions that could contribute to an increased risk of stillbirth, such as:
Antihypertensives: To manage high blood pressure in pre-eclampsia or chronic hypertension.
Insulin or other medications: To manage gestational diabetes.
Antibiotics: To treat maternal infections.
Corticosteroids: May be used in premature labor to help with fetal lung development (though premature labor may lead to stillbirth in some cases).
Anti-D immunoglobulin (RhoGAM): Given to Rh-negative mothers to prevent Rh sensitization. After a stillbirth, medications may be used to induce labor if it does not begin spontaneously, such as:
Misoprostol: A prostaglandin used to soften the cervix and induce contractions.
Oxytocin (Pitocin): A synthetic hormone used to stimulate contractions.
Is Communicable
Stillbirth itself is not communicable. However, some of the underlying causes of stillbirth, such as certain maternal infections (e.g., Listeria, CMV, parvovirus B19), *can* be communicable. These infections can be transmitted from the mother to the fetus.
Precautions
While not all stillbirths are preventable, some precautions can help reduce the risk:
Prenatal care: Regular prenatal checkups are crucial for monitoring the health of both the mother and the baby.
Manage existing health conditions: Properly manage any pre-existing health conditions, such as diabetes or high blood pressure.
Healthy lifestyle: Maintain a healthy weight, eat a balanced diet, and avoid smoking, alcohol, and illicit drugs.
Vaccinations: Stay up-to-date on vaccinations, especially those recommended during pregnancy (e.g., flu, Tdap).
Avoid infections: Practice good hygiene to minimize the risk of infections.
Fetal movement monitoring: Be aware of fetal movement and report any significant changes to your doctor.
Genetic counseling: If there is a family history of genetic disorders, consider genetic counseling.
Awareness of Risk Factors: Be aware of and discuss risk factors with your doctor.
How long does an outbreak last?
Stillbirth is not an "outbreak" in the sense of a contagious disease. It is an individual event.
How is it diagnosed?
Stillbirth is diagnosed when a healthcare provider cannot detect a fetal heartbeat using a Doppler ultrasound or other fetal monitoring device after 20 weeks of gestation. An ultrasound examination is typically performed to confirm the absence of fetal cardiac activity.
Timeline of Symptoms
Stillbirth itself does not have a timeline of symptoms for the fetus. As described above, the mother might experience symptoms indicating a problem, but they do not always occur before a stillbirth. If they occur, they may present acutely or develop over a few days.
Important Considerations
Emotional Support: Stillbirth is a profoundly traumatic experience. Parents and families need compassionate emotional support from healthcare providers, family, friends, and support groups.
Autopsy: An autopsy may be recommended to help determine the cause of death, although families have the right to decline.
Genetic Testing: Genetic testing of the fetus or placenta may be helpful in identifying potential genetic causes.
Recurrence Risk: Discuss the risk of recurrence in future pregnancies with your doctor.
Grief Counseling: Grief counseling is highly recommended to help parents cope with their loss.
Planning for Future Pregnancies: Discuss the timing of future pregnancies and any necessary precautions with your healthcare provider.
Legal and Administrative Aspects: There are legal and administrative aspects to consider, such as obtaining a birth certificate and/or death certificate.