Deciphering Stillbirth: Common Causes and Tests
Simple blood tests should be performed on the mother to test for possible causes of the stillbirth, including:
- Feto-maternal hemorrhage
- Antibody problems
There is still some controversy over whether the physician should do a genetic amniocentesis, in which cells from the amniotic fluid are obtained before the baby is delivered. Douglas and Dr. Sussman write that these cells can offer valuable clues for up to two weeks after the death of the fetus. In contrast, they say, cells obtained after delivery often can’t provide such useful evidence.
Dr. Dudley, however, does not include this test with the battery he and his researchers are performing with the SCRN study. “Research has not conclusively shown that this is any more useful than the tests on the placenta and the fetus,” he says.
As sad and as difficult as it is for parents to think through these questions about testing, it is a very important part of healing. Currently, many parents must somehow accept that they’ll never know why their babies died, many during seemingly uneventful pregnancies. However, studies have shown that the cause of fetal death can be determined in 80 to 90 percent of cases if all the above outlined tests (blood and urine tests, autopsy, cord examination, and placental examination) are performed. That’s substantially better than the traditionally accepted 60 percent rate of unexplained stillbirths.
Knowing how or why a baby was stillborn doesn’t bring the baby back, but it does provide a measure of understanding and closure. It also can offer the couple and their physician important information about how to manage a subsequent pregnancy. There is hope that, just as we’ve learned more about SIDS and informed the public, stillbirth rates will fall just as SIDS rates have plummeted over the past decade.
“Stillbirth is a relatively common important public health issue because it reflects on the quality and quantity of prenatal case and on the general health of a population, and it always tragic,” says Dr. Dudley. Many parents are hoping and praying that research done both on a personal and a large-scale level will provide valuable answers to understanding this silent killer.
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