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stillbirth
death of a fetus in the uterus or during labor or delivery
Etiology:
- maternal or fetal infection (13-20%) [4]
- Escherichia coli > multiple organisms > group B streptococcus, enterococcus
- less common: syphilis, cytomegalovirus, parvovirus , herpes simplex virus [4]
- risk factors [2]
- obesty
- smoking
- older age
- preexisting diabetes
- hypertension
- primiparity
- placental abruption
- small-for-gestational-age fetus
Epidemiology:
- most stillbirths occur in full term pregnancies [1]
- non-Hispanic black women more susceptible to infection-related stillbirth than white women [4]
Differential diagnosis:
- miscarriage: before 24* weeks of gestation
- stillbirth: after 24* weeks of gestation
* 24 is arbitrary: UK definition [1]
Management:
- guidelines for investigation [2]
- conception within 6-12 months after a stillbirth does not appear to increase risks for adverse pregnancy outcomes [3]
Specific
lithopedion
General
perinatal disease
References
- Wikipedia: Stillbirth
http://en.wikipedia.org/wiki/Stillbirth
- Flenady V et al.
Major risk factors for stillbirth in high-income countries:
A systematic review and meta-analysis.
Lancet 2011 Apr 16; 377:1331.
PMID: 21496916
- Regan AK, Gissler M, Magnus MC et al
Association between interpregnancy interval and adverse birth outcomes
in women with a previous stillbirth: an international cohort study.
Lancet. Feb 28, 2019
PMID: 30827781
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32266-9/fulltext
- Page JM, Bardsley T, Thorsten V et al.
Stillbirth associated with infection in a diverse U.S. cohort.
Obstet Gynecol 2019 Dec; 134:1187.
PMID: 31764728