The risk of stillbirth after 32 weeks of gestation increases with gestational age, and half of these late fetal deaths occur at term.
While the risk of stillbirth is increased in pregnancies that go beyond 42 weeks, it is still relatively small, at 4 to 7 deaths per 1000 deliveries, as opposed to 2 to 3 deaths per 1000 deliveries in women who deliver between 37 and 42 weeks.
An early stillbirth is a fetal death occurring between 20 and 27 completed weeks of pregnancy. A late stillbirth occurs between 28 and 36 completed pregnancy weeks. A term stillbirth occurs between 37 or more completed pregnancy weeks.
“This is considered to play a role in the stillbirths and poor outcomes after delivery,” Thangaratinam said by email. At 37 weeks, the risk of stillbirth was roughly 1 for every 10,000 pregnancies, the study found. This risk steadily rose, reaching roughly 32 stillbirths for every 10,000 pregnancies by 42 weeks.
Stopping of fetal movement and kicks. Spotting or bleeding. No fetal heartbeat heard with stethoscope or Doppler. No fetal movement or heartbeat seen on ultrasound, which makes the definitive diagnosis that a baby is stillborn.
Stillbirth in Australia
In Australia, 6 babies are stillborn each day, affecting more than 2,000 Australian families each year.
After a fetus dies, labour will usually begin on its own within 2 weeks. Many women don't want to wait that long. They choose to have labour induced. This means going to the hospital and, usually, getting medicine that starts the labour process.
In more than 1 of every 10 stillbirths, the fetus had a genetic or structural birth defect that probably or possibly caused the death. Infection. In more than 1 of every 10 stillbirths, the death was likely caused either by an infection in the fetus or in the placenta, or by a serious infection in the mother.
The most common causes of stillbirth include placental problems (such as placental abruption or other conditions that prevent the placenta from supplying enough oxygen and nutrients to the fetus), chromosomal abnormalities, and infection.
Most women less than 20 weeks of pregnancy do not notice any symptoms of a fetal demise. The test used to check for a fetal demise in the second trimester is an ultrasound examination to see if the baby is moving and growing. Fetal demise is diagnosed when the ultrasound examination shows no fetal heart activity.
The baby may also benefit. The risk of an unexplained or unexpected stillbirth may be reduced by cesarean section, as may be the risk of complications of labour such as clinical chorioamnionitis, fetal heart rate abnormalities and cord prolapse.
being over 35 years of age. smoking, drinking alcohol or misusing drugs while pregnant. being obese – having a body mass index above 30. having a pre-existing physical health condition, such as epilepsy.
The 39-week rule means that a pregnant woman who has an identifiable risk factor for stillbirth but who does not have an accepted “indication” for labor induction has no choice but to wait until at least 39 weeks 0 days before she can be delivered.
What causes a stillbirth? There can be a number of reasons why a baby is stillborn however sometimes a cause cannot be found. In Australia, the major causes of stillbirth are infection, the health of the mother, bleeding, a premature labour that cannot be stopped or an abnormality with the developing baby.
Unemployed mothers were similarly more likely to have stillborn babies (2.85x higher risk - 6.12% vs 1.32%). High levels of perceived stress were shown to double the risk of stillbirth (3.57% vs 1.17%) independent of other social factors and pregnancy complications that can put pressure on mothers.
Research has shown that in the third trimester (after 28 weeks of pregnancy) going to sleep on your back increases your risk of stillbirth. As the link has now been shown in four separate research trials, our advice is to go to sleep on your side in the third trimester because it is safer for your baby.
About half of all stillbirths happen after 28 weeks of pregnancy; many remain unexplained. Rates are even worse in low-income countries, but the U.S. stillbirth rate is higher than that of many other Western countries.
Most babies born unexpectedly without a heartbeat can be successfully resuscitated in the delivery room. Of those successfully resuscitated, 48% survive with normal outcome or mild-moderate disability.
Most babies (91%) in Australia are born at term (37–41 weeks). This is similar across the states and territories and has been stable over time.
Epidemiology/Incidence: About 15% of women giving birth in the US are 35 years or older, and 2.6% are age 40 or older. The risk of stillbirth in women age 35-39 is about 11-14/1,000 births and is 11-21/1,000 births in women 40 years and older.
Stillbirths were concentrated in a few countries, with the greatest number found in India, followed by Pakistan, Nigeria, the Democratic Republic of the Congo, Ethiopia and Bangladesh.
Even though labor and vaginal birth can be hard work, they are generally easier on a woman's body than a cesarean. Recovery after vaginal birth is usually shorter and less painful than after a C-section, and allows the woman to spend more time with her baby.