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Outcome of resuscitation following unexpected apparent stillbirth


There are few data to inform a decision to resuscitate babies who are unexpectedly stillborn. The outcome for 42 successfully resuscitated stillborn children, of whom 62% survived to be discharged home, is reported. Of the survivors, a poor outcome with severe disability was found in 23% (including one postneonatal death), equivocal outcome was found in 15% (two mild hypertonia; two with mild hemiplegia and no associated other disability) and 62% were free of any impairment at follow up 20 months to 8 years later. In 39 (93%) fetal problems had been identified and the resuscitation team was present at delivery. Poor outcome was associated with late return of heart beat, delayed respirations, neonatal acidaemia and early onset of seizures. Of the unexpected apparent stillbirths successfully resuscitated, 52% died or survived severely disabled, 10% had an equivocal outcome, but 36% survived apparently intact. Therefore, vigorous resuscitation is clearly indicated in these circumstances.

  • Unexpected stillbirth occurs in 0.5/1000 births over 24 weeks of gestation; most have indentifiable obstetric or perinatal antecedents

  • Over 60% of these infants are successfully resuscitated; of these, over 60% have no long term disability, but one in five do

  • Poor outcome of resuscitation, both long and short term, is associated with late return of heart beat/respiration, the presence of acidaemia in the first 2 hours after birth, and early onset of seizures

  • Vigorous resuscitation of unexpectedly stillborn infants is clearly indicated

  • stillbirths
  • resuscitation
  • disability

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