Obstetric Care Consensus #10: Management of Stillbirth

Gynecologists,; Metz, Torri D.; Berry, Rana Snipe; Fretts, Ruth C.; Reddy, Uma M.; Turrentine, Mark A.

doi:10.1016/j.ajog.2020.01.017

Cited by 45 publications

(46 citation statements)

References 117 publications

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“…Approximately 40% of the patients who gave birth in our hospital were Syrian immigrants. Ethnicity was thought as a cause in increasing stillbirth, such as the non-Hispanic black race [12]. Comparison of the groups in terms of race was significantly different; however, we did not find any significant differences between the Turkish and Arabic women in multivariate logistic regression analysis.…”

Section: Discussioncontrasting

confidence: 69%

“…Contemporary studies have reviewed the possible reasons for stillbirth. Evaluation of the stillbirth was suggested in terms of detailed medical and obstetric history, an autopsy of the baby, placental pathology, genetic evaluation, Lupus, feto-maternal hemorrhage diseases, infections, inherited thrombophilia, endocrinologic diseases [11,12]. Despite these all investigations, most stillbirths remained unexplained.…”

Section: Discussionmentioning

confidence: 99%

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The risk factors and maternal adverse outcomes of stillbirth

Şimşek¹,

Demirci²,

Çakmak³

2021

Journal of Surgery and Medicine

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Section: Discussioncontrasting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

The risk factors and maternal adverse outcomes of stillbirth

Şimşek¹,

Demirci²,

Çakmak³

2021

Journal of Surgery and Medicine

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“…Recently, all major obstetrics and gynaecology associations, such as the Royal College of Obstetrics and Gynaecology (RCOG) and the American College of Obstetrics and Gynaecology (ACOG), have highlighted the importance of quality care for patients with stillbirths [43,44]. In this audit, we could identify elements of substandard care after the stillbirth occurred, such as incomplete diagnostic protocols in 17.7% of the cases.…”

Section: Causes Of Deathmentioning

confidence: 99%

Could a multidisciplinary regional audit identify avoidable factors and delays that contribute to stillbirths? A retrospective cohort study

Sterpu

Bolk

Öberg

et al. 2020

BMC Pregnancy Childbirth

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Background The annual rate of stillbirth in Sweden has remained largely unchanged for the past 30 years. In Sweden, there is no national audit system for stillbirths. The aim of the study was to determine if a regional multidisciplinary audit could help in identifying avoidable factors and delays associated with stillbirths. Methods Population-based retrospective cohort study. Settings: Six labour wards in Stockholm County. Participants: Women delivering a stillbirth > 22 weeks of gestation in Stockholm during 2017. Intervention: A multidisciplinary team was convened. Each team member independently assessed the medical chart of each case of stillbirth regarding causes and preventability, level of delay, the standard of healthcare provided, the investigation of maternal/foetal diseases and if any recommendations were given for the next pregnancy. A decision was based on the agreement of all five members. If no agreement was reached, a reassessment of the case was done and the medical record was scrutinized again until a mutual decision was made. Primary outcomes: The frequency of probably/possibly preventable factors associated with a stillbirth and the level of delay (patient/caregiver). Secondary outcomes: The causes of death, the standard of antenatal/intrapartum/postpartum care, whether a summary of possible causes of the stillbirth was made and if any plans for future pregnancies were noted. Results Thirty percent of the stillbirths were assessed as probably/possibly preventable. More frequent ultrasound/clinical check-ups, earlier induction of labour and earlier interventions in line with current guidelines were identified as possibly preventable factors. A possibly preventable stillbirth was more common among non-Swedish-speaking women (p = 0.03). In 15% of the cases, a delay by the healthcare system was identified. Having multiple caregivers, absence of continuity in terms of attending the antenatal clinic and not following the basic monitoring program for antenatal care were also identified as risk factors for a delay. Conclusion A national/regional multidisciplinary audit group retrospectively identified factors associated with stillbirth. Access to good translation services or a more innovative approach to the problem regarding communication with mothers could be an important factor to decrease possible patient delays contributing to stillbirths. Trial registration NCT04281368.

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“…However, it is suggested to report fetal deaths at 20 or more weeks or weight greater than or equal to 350 grams if the gestational age is not known. 3 In a developing country like Nepal, the period of viability for a fetus is later than that in a developed country and IUFD can be defined as fetal death occurring after 28 weeks period of gestation. 4 Stillbirth is a significant contributor of perinatal mortality and is defined by WHO as the number of stillbirth and deaths in the first week of life per 1000 live births.…”

Section: Introductionmentioning

confidence: 99%

Factors Related to Late Intrauterine Fetal Death in a Tertiary Referral Center: A Retrospective Study

Kuikel¹,

Shrestha²,

Bajracharya³

et al. 2021

Europasian J Med Sci.

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Backgroun: Intrauterine fetal death (IUFD) is a contributor of perinatal outcome and is an important indicator of the quality of antenatal care. Despite efforts, risk factors cannot be identified in cases of intrauterine fetal deaths. This study aims to identify the maternal, fetal, placental and cord related factors related to it. Methods: It is a retrospective cross-sectional study conducted analyzing patients admitted with IUFDs after 28 weeks of pregnancy at Tribhuwan University Teaching Hospital from April 2019 to March 2020. It was conducted after taking ethical approval from Institutional Review Committee (IRC) of Institute of Medicine. Data were collected from review of charts of individual patients in MS Excel and was analyzed using SPSS. Results: There were 5496 births and 46 intrauterine fetal deaths during the study period giving stillbirth rate of 8 per 1000 births. It was common in the age group of 26-30 years (34.8%), 62.2% were from inside Kathmandu valley,43.5% were just literate, 13% were illiterate, 84.8% were housewives, 56.5% were primigravida and 69.57% of the babies were preterm. Only four percent had previous history of intra uterine fetal deaths. Hypertensive disorders complicating pregnancy were found in 30.5% followed by heart disease in 10.9% of the mothers. There were no known co-morbidities in 26.1% of the patients. Out of total 46 cases, 62% were female. Two had Rh isoimmunization and four had congenital malformations. Placenta previa was seen in four percent and abruptio placenta in two percent. Twin pregnancy with diamniotic dichorionic placenta was present in four percent. Seventeen percent of the babies had cord around the neck and two percent had thrombosis of the umbilical cord. Conclusion: Low level of maternal education and maternal comorbidities like hypertensive disorders complicating pregnancy were found to be most common factors seen in cases of intrauterine fetal deaths.

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Obstetric Care Consensus #10: Management of Stillbirth

Cited by 45 publications

References 117 publications

The risk factors and maternal adverse outcomes of stillbirth

The risk factors and maternal adverse outcomes of stillbirth

Could a multidisciplinary regional audit identify avoidable factors and delays that contribute to stillbirths? A retrospective cohort study

Factors Related to Late Intrauterine Fetal Death in a Tertiary Referral Center: A Retrospective Study

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