Stillbirth

Intrauterine fetal death, also known as stillbirth, is the death of the fetus that occurs after the 20th week of gestation and before birth.

The cause of fetal death can be maternal, fetal or placental.

• Maternal causes: Advanced maternal age, malnutrition, active smoking, alcohol or drugs. Chronic diseases such as lupus, diabetes, high blood pressure or preeclampsia. Pregnancy that lasts more than 42 weeks or that presents infections in its evolution.
• Fetal causes: Intrauterine growth retardation, amniotic fluid disorders, infections, congenital malformations or multiple pregnancy.
• Placental causes: Placental abruption, umbilical cord knots or placenta previa.

In many patients, the only clinical data obtained is the recent absence of fetal movements. On physical examination, the absence of fetal heartbeat suggests fetal death. Fetal death must be confirmed by ultrasound. To ensure a diagnosis, direct observation of the fetal heart and its proof of cardiac absence is performed.

If confirmed, the patient should be admitted to induce labor, a study of the possible causes of fetal death should be performed, and the necessary psychological support should be provided.