Pregnancy Loss and Potential Causes of Stillbirth
Parents experiencing pregnancy loss may seek additional testing in an effort to determine the cause of loss. Most of the time, loss occurs for reasons parents have no control over. In fact, it's often difficult to pinpoint the exact cause. On the other hand, learning the cause of a pregnancy loss may help put your mind at ease and help you improve your chances for having a healthy, full-term pregnancy in the future.
You can choose whether you want testing done to help determine the cause of pregnancy loss. If the loss occurred after the 20th week, you can also choose whether you want your baby to have a post-mortem exam. Your healthcare provider is a great resource to help you make the right decision for your family. To discover the cause, your healthcare provider may perform one or more of the following tests:
Blood Tests. Blood tests will show if the mother had preeclampsia, obstetric cholestasis or diabetes.
Examination of the umbilical cord, membranes and placenta. These tissues attach to your fetus. An abnormality could prevent your baby from receiving oxygen, blood and nutrients.
Tests for infection. Healthcare providers will take a sample of the mother’s urine, blood, or cells from her vagina or cervix to test for infection.
Thyroid function test. This test will determine if there’s something wrong with the mother’s thyroid gland that may have impacted the pregnancy.
Genetic tests. Your healthcare provider will take a sample of the umbilical cord to determine if your baby had genetic problems such as Down’s syndrome.
Your healthcare provider will also review medical records and the circumstances surrounding the stillbirth. With your consent, an autopsy can be performed to determine the cause of your baby's death. In some cases, an autopsy may be legally required. An autopsy is a surgical procedure performed by a skilled pathologist. Incisions are made carefully to avoid any disfigurement, and the incisions are surgically repaired afterward. You have the right to limit the autopsy to eliminate any incisions on your baby that are uncomfortable for you.
Common Causes of Stillbirth
A stillbirth is defined as a pregnancy loss that occurs after 20 weeks; they can happen to pregnant women of any age, background, or ethnicity. Stillbirths can be unpredictable – approximately 1/3 of cases go unexplained. When possible, knowing what caused the stillbirth is helpful not only for the healthcare providers to know, but for the parents to help with the grieving process. The most likely causes of stillbirth include:
Problems with the placenta or umbilical cord. Your placenta is an organ that lines your uterus when you’re pregnant. The fetus gets blood, oxygen and nutrients through the placenta and umbilical cord. Problems with your placenta or umbilical cord will result in the fetus will not developing properly.
Preeclampsia. Preeclampsia is high blood pressure and swelling that often happens late in the pregnancy. If you have preeclampsia, you have twice the risk of placental abruption or stillbirth.
Lupus. A mother who has lupus is at risk of having a stillbirth.
Blot Clotting Disorders. A mother who has a blood clotting disorder like hemophilia is at a high risk.
Pre-Existing Maternal Illness. Other maternal illnesses can sometimes cause stillbirths. The list includes diabetes, heart disease, thyroid disease, or a viral or bacterial infection.
Lifestyle Choices. If your lifestyle includes drinking, using recreational drugs and/or smoking, you’re more likely to have a stillbirth.
Undetected Birth Defects. One or more birth defects are the cause of about 25% of stillbirths. Birth defects are rarely discovered without a thorough examination of the baby, including an autopsy (an internal examination of the baby’s body).
Various Infections. An infection between week 24 and week 27 can cause a fetal death. Usually, it’s a bacterial infection that travels from your vagina to the womb. Common bacteria include group B streptococcus, E. coli, klebsiella, enterococcus, Haemophilus influenza, chlamydia and mycoplasma or ureaplasma. Additional problems include rubella, the flu, herpes, Lyme disease and malaria, among others.
Trauma. Traumatic events, such as a car crash, can result in a stillbirth.
Intrahepatic cholestasis of pregnancy (ICP). Also known as obstetric cholestasis, this is a liver disorder that includes severe itching and may be linked to an increased risk of stillbirth.
Emotional healing from pregnancy loss may take much longer than physical healing, particularly if you have unanswered questions about what caused the loss. Pregnancy loss can be a heart-wrenching loss that others around you might not fully understand. Your emotions might range from anger and guilt to despair. Give yourself time to grieve the loss of your pregnancy, and seek help from loved ones. BenefitBump’s Care Navigators are here to help provide emotional support and counseling resources for you and your family throughout your loss journey.
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