Intrauterine Fetal Death - Stillbirth

Stillbirth is a term used to describe a baby that dies before delivery but after 20 weeks of pregnancy. It is slightly different than a miscarriage. Miscarriage describes a fetus that dies before 20 weeks of pregnancy.

What is going on in the body?

The death of a stillborn infant occurs while it is still inside the mother's womb, or uterus. It can occur due to several different and often unknown causes. A stillbirth can be emotionally devastating to the parents.

What are the causes and risks of the condition?

Some of the known causes of stillbirth include:

Other causes are also possible. In at least 50% of the cases, the cause is not known.

What are the signs and symptoms of the condition?

Certain signs and symptoms make a healthcare provider suspect a possible stillbirth. These include:

How is the condition diagnosed?

A history and physical exam are done first. If the mother has not yet given birth, a pregnancy ultrasound test is done. This can show whether the baby is moving and whether his or her heart has stopped. If delivery occurs, the baby will be dead at the time of delivery.

What can be done to prevent the condition?

Prevention is sometimes possible, by avoiding certain pregnancy risk factors.

What are the long-term effects of the condition?

The long-term effects are often psychological. The parents can be devastated by the loss of the baby. Some may grieve for months or even years.

A baby that is not delivered shortly after death can cause physical problems in the mother as well. These problems include infections of the uterus and problems with blood clotting, a serious problem known as disseminated intravascular coagulation, or DIC.

Other long-term effects are related to the cause of the stillbirth. For example, autoimmune disorders can cause damage to different parts of the mother's body, such as the kidneys, brain, and skin. Diabetes also affects many different organs, such as the kidneys, heart, and nerves.

What are the risks to others?

A stillbirth is not contagious. In rare cases, the infection that caused the stillbirth can be contagious, such as rubella, fifth disease, and cytomegalovirus.

What are the treatments for the condition?

If a woman has delivered the baby, she is observed briefly to make sure she is stable. If a woman has not yet delivered, medications are often given to cause delivery. In some cases, a woman may simply be observed for a brief period to see if she delivers on her own. Many women prefer that labor be induced right away. The baby may be delivered by cesarean section if medications fail to start labor.

Any infection or blood-clotting problem is treated if necessary. This may involve antibiotics for an infection, or blood transfusions or blood-thinning medications for clotting problems.

Emotional support is also given as needed.

What are the side effects of the treatments?

The side effects depend on the treatment given to a mother who has a stillbirth.

What happens after treatment for the condition?

Once the baby is delivered and the mother is stable, an attempt is made to determine the cause of the stillbirth. This may include blood tests or tissue samples taken from the mother's vagina, cervix, or uterus. In addition, an autopsy of the baby may be done if the parents permit it. An autopsy is a thorough inspection of a dead body that may reveal a cause of death.

How is the condition monitored?

The woman is often monitored briefly in the hospital after delivery of a stillborn infant. The monitoring may include blood tests. The woman can go home once she is physically and emotionally stable. Further monitoring depends on the cause of the stillbirth, if one is known. For example, a woman with diabetes needs lifelong monitoring of her blood sugar levels.

Author:Adam Brochert, MD
Date Written:
Editor:Smith, Mary Ellen, BS
Edit Date:07/18/00
Reviewer:Lama Rimawi, MD
Date Reviewed:06/07/01

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