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Stillbirth in a DGH – risk factors analysis
  1. S Sibtain1,
  2. D Janga2,
  3. P Sinha1
  1. 1Conquest Hospital, East Sussex NHS Trust, East Sussex, United Kingdom
  2. 2Homerton University Hospital, London, United Kingdom

Abstract

Objectives To evaluate identifiable risk factors in women with pregnancies affected by a stillborn fetus.

Methods This is a retrospective study of 4 years (2006 to 2009) in ESHT. The inclusion criteria were stillbirths after 24 weeks. The exclusion criteria were twin pregnancy with single fetus demise under 24 weeks. The demographic details, predisposing risk factors, body mass index, and baby's details were collected and analysed.

Results Sixty five women were identified for the study (0.4% of all deliveries) but only 62 case notes (95.4%) were identified. The ethnic distribution were (87%) Caucasian, (8%) Black Africans, (2%) Asians and 3% unknown. 37% were primiparous. In 58% the booking BMI was <30, 11% were obese and in 31% not recorded. In 61% there was an identifiable risk factor (17% had ante-partum haemorrhage and 14% had pregnancy induced hypertension). Almost one third of the women (30%) smoked. In 19% the loss was after 38 weeks. 57% of the babies were male. In only 76% of the cases post-mortem examination was performed out of which 25.8% had no pathology.

Conclusions Loss of a baby after 24 weeks can be extremely distressing to the couple as well as to the health care personnel involved. As per CEMACH suboptimal intrapartum care was identified in 40-75% of cases. It is a challenge to care for these women in subsequent pregnancies. A close antenatal surveillance with adequate emotional support is the cornerstone in management of these women.

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