Stillbirth: Obstetric conditions

Abstract

IntrOductIOnStillbirth is one among the most tragic obstetric complications. Over the past half century, considerable progress has been made by reducing the risk of stillbirth due to a variety of conditions including red cell alloimmunization, hypertension, and diabetes. However, stillbirth rates have stabilized over the past 20 years with a rate of 6.2 per 1,000 live births in the United States in 2004.(1) Studies of stillbirth often focus on genetic problems, fetal malformations, infections, and maternal medical conditions. However, a meaningful proportion of stillbirths are due to obstetric complications. Such conditions include fetalmaternal hemorrhage, cord abnormalities, placental abruption, amniotic band syndrome, multiple gestation, uterine abnormalities, cervical insufficiency, preterm labor, preterm premature rupture of membranes, placenta previa, and preeclampsia. Taken together, these disorders account for approximately 20% to 45% of stillbirths.(2-6) However, these numbers should be considered with caution. Many cases of stillbirth may be attributed to obstetric complications such as a cord accident without sufficient proof of causality. This chapter will review the association between these conditions and stillbirth with an emphasis on diagnosis, treatment, and prevention.

The impact of maternal age on fetal death: does length of gestation matter?

“…In Europe, 2% of pregnancies with congenital anomalies result in fetal death. 31 The global rates of fetal death caused by congenital anomalies vary, and depend on maternal nutrition, environmental exposures, availability of prenatal diagnostic tools and access to induced abortion at the woman's request. 32 Infections.…”