Stillbirth

What is a stillbirth?

From: MedlinePlus, National Library of Medicine

If you lose a fetus at or after the 20th week of pregnancy, it's called a stillbirth. A stillbirth can occur before or during delivery and may be considered as:

• Early. The loss of a fetus between 20 and 27 weeks of pregnancy.
• Late. The loss of a fetus between 28 and 36 weeks of pregnancy.
• Term. The loss of a fetus at 37 or more weeks of pregnancy.

What are the risk factors for stillbirth?

From: MedlinePlus, National Library of Medicine

Stillbirth can happen in any pregnancy. Some factors may increase the chance that one can occur. Risk factors can include if you:

• Are age 35 years or older
• Are of low socioeconomic status
• Smoke during pregnancy
• Have certain medical conditions, such as diabetes or high blood pressure
• Are a non-Hispanic Black woman
• Previously had a stillbirth
• Are pregnant with more than one baby (twins or triplets)

What are the possible causes of stillbirth?

From: MedlinePlus, National Library of Medicine

In many cases, the cause remains unknown. Some causes may be preventable, but most are not.

Causes for a stillbirth may include:

Problems with the placenta, the organ that carries oxygen and nutrients to the fetus

Genetic problems with the fetus

Fetal infections

Other physical problems in the fetus

Problems with the umbilical cord during labor and delivery

How is a stillbirth diagnosed?

From: MedlinePlus, National Library of Medicine

Before delivery, the only way to diagnose a stillbirth is to check if the fetus's heart is beating. Your health care provider may use an ultrasound to look for the fetal heartbeat.

During your pregnancy, your provider may recommend keeping track of fetal movements. However, if you don't notice movement, it doesn't always mean a stillbirth occurred. Sometimes, especially if it's your first pregnancy, it might be difficult to notice movement. If you're pregnant and something seems unusual or is worrying you, talk to your provider.

After labor and delivery, your provider will check the baby for signs of life. These can include breathing, heartbeat, voluntary movements, and pulsations in the umbilical cord. If one or more signs of life are not present, then life-saving measures are taken. If these measures are unsuccessful, a stillbirth may be diagnosed.

How do health care providers manage a stillbirth?

From: MedlinePlus, National Library of Medicine

Care after a stillbirth depends on when it occurs. If it happens before delivery, your provider may induce (start) labor or use surgery to deliver the fetus (cesarean delivery). If it happens during labor and delivery, the placenta will still need to be removed or delivered.

No matter when it occurs, losing a pregnancy can be difficult. Counseling may help you cope with your grief. Later, if you decide to try to get pregnant again, work closely with your provider to understand any risks. Many women who have a stillbirth go on to have healthy babies.

Understanding terms used in the source

These definitions explain medical words used above. A definition is not evidence that another condition is present, and it does not predict how a symptom will develop. Ask the clinician which terms apply to the actual examination or test result.

Stillbirth

Death of the fetus in utero after at least 22 weeks of gestation.

Healthy

No history of any serious disease, including the disease being investigated in the proband.

Which doctor should you see?

The suggested department for discussing Stillbirth is Obstetrics and Gynaecology, with a obstetrician-gynaecologist as the relevant type of clinician. Obstetrician-gynaecologist; paediatric services for children as appropriate.

This is an editorial referral starting point. The appropriate clinic depends on the person’s age, symptoms, previous diagnosis and local services. The first clinician can decide whether another specialty or a team is needed; a department label does not confirm the diagnosis.

How to prepare for an assessment

Bring a short timeline of the main symptoms: when they first appeared, whether they are constant or episodic, what seems to change them, and how they affect daily activities. Include previous reports, discharge summaries, current medicines and supplements, allergies, and any relevant family history. A dated record is more useful than trying to match every feature in an online article.

Ask the clinician what is already established and what remains uncertain. If a test is suggested, ask what question it answers, what its limitations are and how the result would change the next step. The information here is not an instruction to arrange every possible test. In children, bring growth, developmental and school information if it is relevant to the concern.

• How do age, pregnancy status and reproductive goals affect the assessment?
• Which changes in bleeding, pain or general health need prompt review?
• What are the benefits and risks of the available options in this situation?

Treatment discussions and follow-up

Where the source describes treatments, these are an overview of possible care, not a prescription for an individual. Ask which option applies to the confirmed diagnosis, what benefit is expected, what adverse effects to watch for and how progress will be assessed. Availability, approvals and local practice can differ from the country described in the source.

Before leaving the appointment, clarify the next review date, who will communicate results, and whom to contact if the situation changes. Discuss difficulties with sleep, work, school, mobility, eating or emotional wellbeing when these are relevant. Practical support may require coordination between the treating clinician and other services.

The collected references do not establish a complete prevention or long-term outlook section for this entry. Missing information should not be interpreted as proof that prevention is impossible or that a particular outcome is inevitable. Ask what is known for the exact subtype, stage and personal circumstances, and which uncertainties remain.

When to seek emergency help

Severe breathing difficulty, collapse, new stroke-like symptoms, a seizure that is prolonged or repeated without recovery, uncontrolled major bleeding, or an immediate risk of self-harm require emergency help. In India, call 112 or reach the nearest emergency department. This is a general, non-exhaustive warning list; it is not a condition-specific triage tool.