Stillbirth in the uterus and what you need to know

This is an automatically translated article.

The article is professionally consulted by Specialist Doctor II Tran Thi Mai Huong - Department of Obstetrics and Gynecology - Vinmec Hai Phong International General Hospital.
Intrauterine stillbirth is an unwanted event of any pregnant woman; If not detected in time, it will cause dangerous complications for the mother, especially for women who are pregnant for the first time.

1. What is Thai Save?

In medical terms, cases where a baby dies in the womb for more than 48 hours is called a stillbirth. Stillbirth can occur at any stage of pregnancy, and is usually divided into two groups:
Stillbirths less than 20 weeks of age. Stillbirth group after 20 weeks of age: In this group, it is further divided into early stillbirth from 20-27 weeks of age and late from 28-36 weeks of age. After 37 weeks, it is called a full-term stillbirth. Stillbirth in the uterus causes many dangerous complications for the mother. The first is a blood clotting disorder, the longer the pregnancy stays in the uterus, the higher the risk of clotting disorders. Then there are infectious complications after rupture of membranes leading to sepsis, septic shock, especially caused by Gram-negative bacteria.

2. Causes of stillbirth in the uterus?

There are many different causes of stillbirth, so it is difficult to pinpoint a specific reason. However, stillbirth usually comes from three main groups of causes:
2.1 Causes on the mother's side The mother has chronic diseases such as hepatitis, kidney failure, diabetes, cardiovascular disease, pulmonary tuberculosis.... Hypertension. Gestational hypertension leads to pre-eclampsia, which poses a high risk of death for both mother and baby. The mother has bacterial infections such as gonorrhea, syphilis. Parasitic infections such as: Malaria, especially severe malaria, makes the mortality rate almost 100%. Virus infections such as hepatitis, flu, measles... The mother has endocrine diseases such as: Hypothyroidism, basedow.. The mother works in a toxic environment, hard labor, lacks nutrition. .. The mother uses a lot of stimulants such as alcohol, beer, tobacco, is obese... the possibility of stillbirth is higher than normal. The mother has a uterine malformation that leads to insufficient nutrition for the fetus. 2.2 Causes of the fetus Mother and baby have different blood types. Fetal with birth defects Multiple pregnancy has a phenomenon where the fetuses transfer blood to the placenta, then the fetus is prone to stillbirth. The fetus has genetic defects inherited from the father or mother. The fetus is infected. 2.3 Causes from the pregnant part: Pathologies from the placenta: placental edema, placental abruption...
Abnormalities from the umbilical cord such as knotted, excessively twisted, pinched, wrapped umbilical cord neck or limbs..

3. Clinical symptoms and diagnosis of stillbirth

3.1 Stillbirth under 20 weeks of age 3.1.1 Clinical Vaginal bleeding spontaneously, little by little, blood is dark brown or dark red. Abdominal pain in case of threatened miscarriage or stillbirth. On examination, the uterus was found to be smaller than its gestational age. 3.1.2 Laboratory Tests for hCG in the urine are negative. βhCG levels are lower for gestational age. Ultrasound helps to accurately identify pregnancy status Differential diagnosis: It is necessary to distinguish stillbirth from cases of ectopic pregnancy, ectopic pregnancy, threatened miscarriage, uterine fibroids to avoid unfortunate mistakes. out.
3.2 Stillbirth over 20 weeks old 3.2.1 Clinical The mother does not see the fetus moving, the abdomen does not enlarge but tends to shrink. The mother has a condition of colostrum secretion. Vaginal bleeding, abdominal pain. Disease symptoms such as severe morning sickness, preeclampsia spontaneously subsided. When going to the doctor, the uterus is found to be smaller than the gestational age, difficult to feel the fetal parts, especially the fetal heart is no longer there. 3.1.2 Subclinical When the fetus is after 20 weeks of age, it is possible to have an accurate ultrasound result of the fetal status. X-ray: If the fetus is stillborn, there will be images of a stack of skull bones, a bent spine... however this method is no longer used today because of the danger to the pregnant mother and fetus.

4. What should mothers do when stillbirth?

When the pregnant mother is diagnosed with stillbirth in the uterus, the doctor will appoint the fetus out, anti-coagulation and infection treatment.
Before giving birth, the doctor will do blood count tests, complete blood coagulation function, especially blood fibrinogen, if there is anticoagulant dysfunction, then treat immediately before placing stillbirth problem. In addition, good infection control is required, using high-dose systemic antibiotics in combination for 5-7 days.
Letting the pregnancy out can be: Abortion or abortion, labor: This method is used for stillbirths where the uterine volume is larger than the 3 months pregnant uterus.
Stillbirth is an undesirable thing for any pregnant mother, it severely affects the psychophysiology of pregnant women, especially the psychology of carrying a dead fetus. Doctors and family members need to encourage and explain in detail so that pregnant women can avoid negative effects from this pregnancy.
Vinmec International General Hospital is currently implementing Maternity Care Packages, performed by a team of leading doctors and nurses with both expertise and experience in maternity, with the support of a machine system. Modern technology helps to monitor and diagnose problems during pregnancy, especially stillbirth, to achieve high efficiency and accuracy.
Doctor Tran Thi Mai Huong has 25 years of experience in examination and treatment in the field of Obstetrics and Gynecology, lower tract surgery, laparoscopic surgery. Has held the position of deputy head of the School of Obstetrics and Gynecology, deputy head of the delivery department - Hai Phong Obstetrics and Gynecology Hospital.
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