Stillborn Birth: Causes, Symptoms and Prevention

Stillborn birth is when a baby is born with no signs of life at or after 28 weeks of gestation.  In other words, when a baby dies in the womb.  Gestation is the period which an infant is inside the mother’s body until it is born.

Confirmation of a stillbirth can be done through an ultrasound. A fetal ultrasound is an imaging technique that uses sound waves to produce images of the Festus in the uterus, hence, to evaluate a baby’s growth and development.

This term which describes pregnancy loss is distinct to a miscarriage, which is an early pregnancy loss. The difference lies in when the loss occurs. A miscarriage usually occurs before the 20th week of pregnancy, while a stillbirth after 20 weeks of pregnancy.

Stillbirth can be categorized according to the length of pregnancy.

• An early stillbirth: This occurs between 20 and 27 weeks
• A late stillbirth: This occurs between 28 and 36 weeks.
• A term stillbirth: This occurs between 37 weeks or more

The accelerated progress in technology over the years in terms of prenatal care (medical care during pregnancy) has improved, which has decreased the cases of stillbirth.

Determinant of still birth

According to WHO, in 2015 there were 2.6 million stillbirths globally, with more than 7178 deaths a day. Developing countries had a majority of stillbirth cases.

Access to health care facility, low income level, cultural factors and emotional support has contributed to the factors that promote stillbirth among developing countries such as Africa.

The major causes of stillborn birth.

A change in fetus’ movements or fetal activity can be an indicator of fetal distress or death. A large number of stillbirths happen when the woman is in labour and some still birth cause are preventable.

Below are a few prevalent causes of still birth;

1. Antepartum Hemorrhage (placental abruption, placenta Previa: This is the    malfunctioning of the Placenta. The placenta is an organ that connects the baby and the mother’s blood supply. It supplies the baby nutrients and oxygen. When the placenta has problems, blood supply and nutrient flow will be limited. This restriction puts the baby in danger.
2. The malfunctioning of the umbilical cord: Just like the Placenta, this cord carries the blood and nutrients from the Placenta to the fetus through the abdomen. It attaches the placenta to the fetus. When the cord gets squeezed or tangled, the baby will not get adequate oxygen (Hypoxia) which most likely would lead to death.
3. Birth Defects: An estimation of 1 out of every 10 still birth is caused by birth defects. This estimation was done by the National Institute of Child Health and Human Development. Fetal growth restrictions, structural malformations, genetic conditions can result from genetic, environmental and sometimes unknown causes.
4. Infections: Maternal infection during pregnancy can affect the child, such as HIV, Malaria, syphilis, etc. Bacterial infections within second trimesters causes fetal deaths. This is happening because, these infections sometimes go unnoticed by the mother and may not be diagnosed until when they cause serious complications.
5. Maternal health challenges:  Another major contribution to stillbirths is the mother’s health.  Certain medical conditions such as hypertension in pregnancy, obesity, diabetes in pregnancy, preeclampsia; multiple pregnancies, sickle cell disease (SCDx) in pregnancy, excessive use of alcohol, cigarettes, and drugs are harmful to baby’s health.
6. Injury or accidents during pregnancy and poor progress in labour etc.

Symptoms of stillborn birth

Symptoms depends on the cause however commonly reduction or increase from normal levels of fetal heart rate (gotten in examining the pregnant abdomen) or from USS (also ultrasound scan) and also absent fetal heartbeat.

Same on examination or USS (ultrasound scan), you examine the pregnant woman abdomen with an instrument called a pinard stethoscope.

A pinard stethoscope is used to listen to the heart rate of a Festus during pregnancy.  Also, an examination can also be through handheld Doppler to detect abnormal fetal heart rate or absent fetal heartbeat.

Prevention of stillborn birth

Many stillbirths happen without warning in women irrespective of any risk factors. Some prevention may include:

1. The baby’s kick count should be monitored closely by the mother several times every day, especially during the third trimester.
2. Attend your antenatal appointments regularly which is to start at the 2^nd missed period i.e. 8 weeks of pregnancy. Wherein antenatal detect blood pressure control, sugar control, abnormal fetal heart rate etc. Adequate antenatal care will also provide opportunity to take routine medications in pregnancy and allow assessment of the pregnancy by a health care provider.
3. Eat healthily, folic acid, iron, calcium and vitamin supplements should be added to your diet.
4. If you are the type that smokes, stop smoking and avoid smoky environment for a healthy baby.
5. Stop the intake of alcohol.
6. Practice proper pregnancy sleeping positions.
7. Ensure your doctor is aware of any medications.
8. Regular screening for fetal growth restrictions and pregnancy risks through an ultrasound.
9. Proper management of health conditions prior to conception.

What Happens After a Still Birth?

Labour usually begins after 2 weeks after a Festus dies within the womb. This does not pose a health risk to the mother. The remains would naturally be expelled vaginally.

The more time the death Festus stays in the mother’s body, the higher the risk of developing blood clots. At this point, labour induction is encouraged or surgical procedure known as dilation and evacuation.   Many women don’t wait that long. They choose to have labour induced.

Emotional and mental conditions such as Depression and family breakdown are known complications. In many cases, the trauma experienced may have a long-lasting and deep impact on parents.

General health care

Below are a few health guidelines tips to help increase your knowledge.

Taking care of your body

• Make use of pads instead of tampons for the blood flow.
• Ask your doctor if you can take an over-the-counter pain medicine, such as ibuprofen.
• Ask your doctor about when it is okay to have sex. This gives your body enough time to heal.
• Ensure to have adequate bed rest.
• Seek the comfort of family and friends.
• Try to eat healthy foods and exercise.

Conclusion

Avoid any of the causes of stillborn birth during pregnancy to avoid a bad experience and kindly contact your health care provider if any of these things below happens during pregnancy.

These are red-flags and should not be handled lightly:

• Loss of consciousness.
• Severe vaginal bleeding.
• Severe pain in the belly or pelvis.
• High fever.