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Stillbirth is death and delivery of a fetus after 20 weeks of pregnancy.
Stillbirth most commonly results when the placenta detaches from the placenta too early (placental abruption—see Complications of Pregnancy: Placental Abruption (Abruptio Placentae)). It may occur when women have certain conditions, such as
Sometimes stillbirth occurs when the fetus has a problem, such as a chromosomal or genetic abnormality, a birth defect, or an infection.
Doctors may suspect that the fetus is dead if the fetus stops moving, although movements often decrease as the growing fetus has less room to move. Tests, such as a nonstress test, ultrasonography, or electronic fetal monitoring, may be done to evaluate the fetus (see Normal Labor and Delivery: Monitoring the Fetus ).
To try to identify the cause, doctors do genetic and blood tests (such as tests for infections and clotting disorders). Doctors also recommend evaluating the fetus to look for possible causes, such as infections and chromosomal abnormalities. The placenta and uterus are examined. Often, the cause cannot be determined.
If the dead fetus is not expelled, the woman may be given a drug such as a prostaglandin to cause the cervix to open (dilate). She is then usually given oxytocin, a drug that stimulates labor. If any tissue from the fetus or placenta remains in the uterus, suction curettage is done to remove it (see Family Planning: Abortion). Alternatively, dilation and evacuation (D & E) may be done to remove the dead fetus if a doctor with the special training required to do this procedure is available.
Changes that occur in women after a stillbirth are similar to those that occur after a miscarriage. Women typically feel grief at the loss and require emotional support and sometimes counseling. Whether a later pregnancy is likely to result in a stillbirth depends on the cause.
Last full review/revision December 2008 by Edmund F. Funai, MD
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