Carl R. Darnall Army Medical Center - Health Library

Stillbirth

(Fetal Death; Intrauterine Fetal Death; IUFD)

Definition

Stillbirth is the death of a fetus after 20 weeks of pregnancy. It often happens before labor begins.

Causes ^

Stillbirth may be caused by:

  • Chromosomal disorders
  • Poor fetal growth
  • Infection
  • Complications of pregnancy with more than one fetus
  • High blood pressure or other conditions in the mother
  • The mother has Rh-negative blood and fetus has Rh-positive blood—Rh incompatibility
  • The umbilical cord descends into the vagina too early and cuts off oxygen to the fetus—umbilical cord prolapse
  • A loop or knot in the umbilical cord
  • The placenta separates from the uterus before the fetus is delivered—placental abruption
  • The placenta becomes implanted near or over the cervix—placenta previa

In many cases, the cause is unknown.

Risk Factors ^

Stillbirth is more common for women aged 35 years and older. Other factors that may increase the chance of stillbirth include:

  • • Mother has chronic conditions, such as: obesity, diabetes, high blood pressure, thyroid disease, kidney disease, heart disease, blood clotting disorder, celiac disease, or asthma
  • Infection
  • Smoking, drinking, or using drugs during pregnancy
  • More than one fetus
  • First pregnancy
  • History of stillbirth or miscarriage in a previous pregnancy
  • Poor prenatal care
  • Trauma, such as a car accident

Symptoms ^

Symptoms include:

  • No movement by the fetus
  • Vaginal bleeding in the mother

Diagnosis ^

An ultrasound exam may be done. The doctor will examine the baby and look for a heartbeat.

The cause may be seen with the ultrasound. After birth, other tests may be done to understand the cause.

Abdominal Ultrasound
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Treatment ^

The fetus will need to be delivered. A vaginal birth is the safest option for most. Some may need a cesarean section. The doctor will talk about the options.

Labor may be started with medicine. It may be given through the vagina, as pills, or by IV. Treatment may not be needed if there are other living fetuses.

The birth does not have to happen right away. Problems for the mother may occur if the birth is put off for several weeks.

Therapy

Having a stillborn baby is a traumatic event. Parents will need time to grieve the loss of their child. A therapist who works in pregnancy loss can help. Support group with parents with similar loss can also help.

Prevention ^

Not all stillbirths can be prevented. Steps that can increase your chance of a healthy pregnancy include:

Before Becoming Pregnant

  • Have a visit with their doctor before you become pregnant. Work with your care team to control health issue like diabetes or high blood pressure.
  • Reach and keep a healthy weight. Talk to your doctor about a healthful diet and exercise plan.
  • Take folic acid. It can prevent certain birth defects. It may also reduce the risk of miscarriage or another stillbirth.
  • If there is a risk of genetic issues, consider a genetic counselor. They can tell you what risks your child may have of certain diseases.

During Pregnancy

  • Go to all prenatal care visits.
  • Avoid smoking, drinking, and using drugs.
RESOURCES:

The American Congress of Obstetricians and Gynecologists
http://www.acog.org

American Pregnancy Association
http://www.americanpregnancy.org

CANADIAN RESOURCES:

Health Canada
http://www.hc-sc.gc.ca

Women’s Health Matters
http://www.womenshealthmatters.ca

REFERENCES:

The American Congress of Obstetricians and Gynecologists. ACOG practice bulletin No. 102: Management of stillbirth. Obstet Gynecol. 2009 Mar;113(3):748-61. Reaffirmed 2016.

Stillbirth. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115491/Stillbirth. Updated February 20, 2018. Accessed September 25, 2018.

Stillbirth: trying to understand. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/pregnancyloss/sbtryingtounderstand.html. Updated June 8, 2017. Accessed September 25, 2018.

12/30/2011 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T115491/Stillbirth: Stillbirth Collaborative Research Network Writing Group. Association between stillbirth and risk factors known at pregnancy confirmation. JAMA. 2011;306(22):2469-2479.

12/30/2011 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T115491/Stillbirth: Stillbirth Collaborative Research Network Writing Group. Causes of death among stillbirths. JAMA. 2011;306(22):2459-2468.

8/26/2014 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T115491/Stillbirth: Gaskins AJ, Rich-Edwards JW, et al. Maternal prepregnancy folate intake and risk of spontaneous abortion and stillbirth. Obstet Gynecol. 2014;124(1):23-31.

7/15/2016 DynaMed Plus Systematic Literature Surveillance.http://www.dynamed.com/topics/dmp~AN~T115491/Stillbirth: Saccone G, Berghella V, Sarno L, et al. Celiac disease and obstetric complications: a systematic review and metaanalysis. 2016;214(2):225-234.

Last reviewed September 2018 by EBSCO Medical Review Board Monica Zangwill, MD, MPH  Last Updated: 9/25/2018