Stillbirth

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

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

• Maternal causes: advanced maternal age, malnutrition, active smoking, alcohol or drugs. Chronic diseases such as lupus, diabetes, high blood pressure or pre-eclampsia. Pregnancy that lasts longer than 42 weeks or that presents infections in its evolution.
• Foetal causes: intrauterine growth retardation, amniotic fluid abnormalities, infections, congenital malformations or multiple pregnancy.
• Placental causes: placental abruption, umbilical cord knots or placenta praevia.

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

If confirmed, the patient should be admitted for induction of labour, investigation of possible causes of stillbirth and psychological support.