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PP.81 Pregnancy After Previous Stillbirth
  1. ME Geisler,
  2. K O’Donoghue
  1. Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, University College Cork, Cork, Ireland

Abstract

One in 200 pregnancies ends in stillbirth. The subsequent pregnancy requires increased surveillance and intervention. We aimed to examine management of this pregnancy with maternal and neonatal outcomes.

A retrospective cohort study of subsequent pregnancies in women who had a stillbirth from 2007 to 2011.

One hundred women were identified in a new pregnancy. Median maternal age was 32 years (range 20–44). Median gestational age at prior stillbirth (infant > 500 g) was 34 weeks (range 22 + 6–41 + 4). 25% of the stillbirths were classified as unexplained and 23% were due to a congenital abnormality. Nineteen women (19/100; 19%) had a first trimester miscarriage. Seven women were diagnosed with gestational diabetes (7/81; 9%) and six developed gestational hypertension (6/81; 7%). Median number of antenatal clinic attendances was ten (range 3–21) and median number of ultrasound examinations was six (range 1–22). One woman experienced a stillbirth at 26 weeks due to recurrent non-immune hydrops, two had a preterm placental abruption, and three developed early-onset fetal growth restriction. Eight women (8/81; 10%) delivered preterm (28–36 weeks). The remainder had a term delivery (37 + 0–40 + 5 weeks). Of these, 11 (11/73; 15%) had an elective caesarean section (CS), and 41 (41/73; 56%) underwent induction of labour, with 81% delivering vaginally. Eleven infants were admitted to the neonatal intensive care unit, but there were no significant morbidities.

Pregnancy after stillbirth results in increased medical intervention and a demand on hospital resources. Both can be justified but are of unproven medical benefit. Here, the majority of women delivered a liveborn infant after an uncomplicated pregnancy.

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