Causes of Stillbirth? - Mothering Forums

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#1 of 16 Old 01-16-2006, 03:25 PM - Thread Starter
 
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Hi everyone, kinda new here.
My DH and I lost our first son in April of last year, at 42 weeks. We didn't do an autopsy, and there was no obvious reason for the stillbirth. We are preggers again now, 12.5 weeks (yay!!) and I went to a doctor last week who wants to do a blood test (specifically for what, I don't know) on me and she wants us to get genetic counseling. Our first son was born in the States and we have since moved abroad.. It's not that I'm opposed to getting this testing and stuff (I'm planning on doing it, I just haven't gotten around to it yet) - it's just that I really, really hate doctors (no offense to any MDs/nurses, etc that are here... I know there's good ones out there, lol) and I have a hard time trusting them. I'm a little bit horrified with this pregnancy.. If it happens again I don't know what I'll do with myself. I'm just wondering what these tests and things will really do.. I don't want her to say.. okay. XYZ came up so you're going to have to take ABC pills and DEF shots from now until the rest of your life.. You know what I mean??
Anyway, I'm wondering about the possible causes of stillbirth.. I am not really coming up with anything on my internet research, except for thyroid problems, which I think may have had something to do with what happened to me. I don't know.
I hope this makes sense. Thanks!
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#2 of 16 Old 01-16-2006, 03:43 PM
 
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Welcome. I wish you didn't have to be here, but this is a wonderful place for support! I'm so sorry for your loss. s

In my case, the reason Reagan was stillborn was because her placenta abrupted. Do we know why the placenta abrupted? No, but we have a concrete reason why she was born still.

I hope maybe they can find something doing blood work (like maybe a blood clotting disorder??) and the genetic testing. You may get some answers and then again, there might never be any answers.

, , , mama to Ross , Reagan (8/29/05), Joshua (from Haiti...here NOW due to the earthquake!), and Elijah , born safely 9-8-09.
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#3 of 16 Old 01-16-2006, 03:49 PM - Thread Starter
 
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Did your MDs suggest that you do blood tests and things, Hoosier?
Thanks! I'm sorry for your loss too..
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#4 of 16 Old 01-16-2006, 03:55 PM
 
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Quote:
Originally Posted by sunshinestarr
Did your MDs suggest that you do blood tests and things, Hoosies?
Thanks! I'm sorry for your loss too..
Sorry. I've been editing my post and didn't see your new one.

What happened to me is very rare and I was actually the first patient of my OB's to have this happen so he was really at a loss when it came to advising me about future pregnancies. Before my pp check-up he consulted w/some other doctors and high-risk guys and they all felt my best bet was to wait until we are ready to TTC again, schedule a consult w/a high-risk guy and go over everything with a fine tooth comb. They will do extensive blood work (probably at my next annual exam) and see if there is anything there that would possibly be a red flag. Other than that, it's just "one of those things" that happens. I was at no bigger risk than any other pregnant woman. It just happened.

, , , mama to Ross , Reagan (8/29/05), Joshua (from Haiti...here NOW due to the earthquake!), and Elijah , born safely 9-8-09.
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#5 of 16 Old 01-16-2006, 04:07 PM - Thread Starter
 
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My CNM actually called my whole pregnancy "boring" (before the birth) - there was just nothing to do.. I was textbook until the very end.. sigh.
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#6 of 16 Old 01-16-2006, 04:14 PM
 
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Quote:
Originally Posted by sunshinestarr

My CNM actually called my whole pregnancy "boring" (before the birth) - there was just nothing to do.. I was textbook until the very end.. sigh.
Me too, sunshine. s

, , , mama to Ross , Reagan (8/29/05), Joshua (from Haiti...here NOW due to the earthquake!), and Elijah , born safely 9-8-09.
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#7 of 16 Old 01-16-2006, 06:32 PM
 
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Another textbook perfect case until the end...literally. Ryland's heart stopped beating sometime between 30 seconds before birth (when they took off the monitor) and the one minute apgars...nobody knows. Cause, still unknown. He had heavy meconium aspiration (but there was no meconium in the water until the very last second of birth) and was showing signs of distress during the pushing phase of labor--the OB thinks he may have had an undetected heart defect that caused him to go into distress...

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#8 of 16 Old 01-16-2006, 06:37 PM
 
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There are many causes of stillbirth, yet statisticly speaking there are more deaths that have no explainable reason.
Here are a few causes: Placental Abruption, Knotted Cords, Blood Clotting Disorders, Chormosonal Abnormalities, Uterine Infections and many many more.
My Alexa is part of the statistics that have no real explanation. However we do fit into two catagories, Advanced Maternal Age (over 35) and a post date pregnancy. I also fell in to the "textbook" pregnancy & she still died catagory.

I say go for the blood work. If you do have a blood clotting disorder, it is impartive for your OB to know so that you can be monitored & steps taken during pregnancy to prevent Stillbirth.

Cristina - "If you find it in your heart to care for somebody else, you will have succeeded." Maya Angelou
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#9 of 16 Old 01-16-2006, 07:16 PM
 
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Hi there:

I am so sorry for everyone's losses...

In Ann Douglas' book Trying Again (2000:30-48), she lists the following major causes of stillbirth:

Problems with the baby:
-chromosomal abnormalities

Maternal health problems:
-diabetes, hypertension, heart disease, kidney, liver, lung, parathyroid, and sickle cell disease, lupus, toxemia

infections during pregnancy:
-CMV, Fifth's disease, listeriosis, rubella, toxoplasmosis, STDs

placental problems:
-placental insufficiency, placental abruption, placental previa

problems with the uterus:
-incompetent cervix, fibroids, uterine abnormalities

umbilical cord problems:
-two vessel cords, straight cord, abnormal cord insertion, prolapsed cord, knots, nuchal cord, torsion, cord strictures, amniotic band syndrome

complications from a multiple pregnancy

intrapartum death

She also states that about 60% of stillbirths are unexplained...

Our daughter's death was unexplained as well. We also a a "textbook pg," low-risk and totally normal, under the care of a midwife. We lost out daughter right on her due date and after a normal exam the week before...

The autopsy we had done (and the pathology on my placenta) officially gave the cause of death as unexplained, but several small irregularities turned up in the report that gave a clue as to what went wrong. My placenta was small and there was some evidence of asymmetrical IUGR in the baby (so, the placenta was not functioning well by the end). It showed signs of cellular inflammation that impacted the blood flow, but we aren't if that was caused by infection or not as I never tested positive for any infections. And the cord was inserted "eccentrically," whatever that entails...we tried to have genetic testing done on our daughter, but they could not culture her cells.

I guess the testing depends on your comfort levels and philosophy about this new pg. I know for us, with pg #2, we wanted more testing done in advance and wanted more monitoring to help prevent something similar from happening again, especially as we had no concrete reason for it. We had an amnio done (and chromosomal tests-all normal ) and that helped a bit. I'm actually glad that we did have more testing this time as something new cropped up that was different from last time but could have caused the loss of another baby. I tested positive for Rh antibodies with the 2nd pg (despite the shots to prevent them) and so my second pg had a lot of scans and monitoring to make sure our baby was doing as well as she could (and was not getting too anemic from Rh disease) and we induced and got her out at 37w. She's healthy as can be today...Maybe the Rh stuff was a blessing in disguise (although I hated it at the time with all the stress it caused) as we were able to monitor our DD more frequently and it gave us a little more peace of mind.

So, I guess IMO I would get the bloodwork. There might be some info in there that is helpful when going through this next pg...

Good luck. ((HUGS))

J

Mother to DD#1  s/b @40w 2003 for unknown reasons; DD#2   10 years old; DS  6.5 years old 
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#10 of 16 Old 01-16-2006, 08:58 PM
 
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It looks like you have gotten some really great info here. I just wanted to say how sorry I am for your loss, but also congratulations on your new pregnancy. I know how scary a pregnancy after stillbirth can be. My afterloss baby just arrived on December 1st, and I can tell you that I was a wreck waiting for him. I lost my daughter to a uterine infection, chorioamnionitis. I am sure that there are lots of things that the Dr is looking for, blood clotting disorders are one of the most common. Also several mom's here have lost their babies to rare genetic occurences. So that is also a possibility. Do you really want the tests? If not you don't have to get them. The one thing I learned during my pregnancy was that you have to do whatever it takes to get by. If that means lots of tests, then take lots of tests. If that means just having faith, then you skip the testing. I had a clotting panel done and then 1 ultrasound. I have friends who had many many tests and ultrasounds. You just have to do what makes you feel most comfortable. That is really all you can do.
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#11 of 16 Old 01-16-2006, 11:36 PM
 
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Quote:
Originally Posted by iris0110
You just have to do what makes you feel most comfortable. That is really all you can do.

Shannon, you are so right!!!

Cristina - "If you find it in your heart to care for somebody else, you will have succeeded." Maya Angelou
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#12 of 16 Old 01-17-2006, 03:23 AM
 
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I have my genetic testing on Thursday. I don't really know what they'll do or find. My son was stillborn at 29 weeks but died at 26 weeks. I went to a really crappy hospital, so they didn't do any bloodwork on him, and had lost the genetic bloodwork they had taken from me before I left the hospital. I really wanted to know if there was anything I could do before I got pregnant again, but got pregnant the month after I had my son. So I got into another pregnancy without having any idea if this one is going to end up the same way.

When I went in for one of my monthly appointments, the doctor in training said that his pathology(?) was okay. I said, so they did do tests on him. He replied no, but his physical was fine. I was like no shit... I saw that he had all 10 fingers and toes, and everything was where it was supposed to be.....

So, now I am still in the crappy hospital, but seriously thinking about just going in for another repeat c/s. The doctor I had visited before changing hospitals was so much more "there" for me, and these doctors in training just don't know that much and I feel like I have to teach them....
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#13 of 16 Old 01-17-2006, 01:33 PM - Thread Starter
 
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Wow, everyone, thanks so much for your replies, all of the information and your support. We are planning on doing the tests.. I think that it's probably partly fear of the unknown on my part and the strangeness of doing this is another country where there is a language barrier that's holding me back a bit. Sigh. I just wanna sail through this pregnancy and not have to worry about anything, you know what I mean?
For the people who did do testing and genetic work, was anything (medicinal or no) prescribed to you, or did you have to change what you were doing in any way?
Thanks again...
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#14 of 16 Old 01-20-2006, 01:40 AM
 
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Quote:
Originally Posted by Debstmomy
Here are a few causes: Placental Abruption, Knotted Cords, Blood Clotting Disorders, Chormosonal Abnormalities, Uterine Infections and many many more.
This is kinda OT, kinda not:
I'm more inclined to think a stillbirthed baby that has a knot in it's cord is coincidence, not cause. It's really common, and the cord is extremely thick and resiliant...
I'd be really curious to see studies showing that a 'true knot' actually causes nutrient or oxygen deficiency, let alone death, in a fetus. All I've ever heard is just circumstantial. A stillborn baby that was stillborn "for no reason" also has a knot, so it must be the knot that did it, kind of thing.

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#15 of 16 Old 01-20-2006, 02:36 PM
 
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Bab, yes, I agree, there are many a knotted cord which resulted in live babies. Perhaps cord accidents would have been better wording.
I believe I read research that stillbirths from knotted cords had some abnormality with the cord as well, such as the wartons jelly (what makes it think) was not as plentiful as it should be.

It must also be said that many on this list can be medically managed & still have a live baby. Pre-eclampsia, infections etc. (I hope that does not stir the pot. I know of many babies that died from these things. But in my research as a stillbirth mom, many of these things if caught in time, can still have a happy outcome. An analogy could be, if you are dx with cancer, it doesn't mean you are going to die.)
Just because you have something going on, doesn't mean a stillbirth. I will also reiterate, many stillbirths have no cause. It just is. So Sad.

Cristina - "If you find it in your heart to care for somebody else, you will have succeeded." Maya Angelou
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#16 of 16 Old 01-21-2006, 04:30 PM - Thread Starter
 
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Well I still haven't made any movements to go do the tests. I still say that I'm planning to, though, lol. Being in this crazy country is scary. And I (finally) spoke to my DH about this and he's totally against the tests... This was news to me. He has the same fears that I do.. (OT - And he's all of a sudden totally anti-vax! That was big news to me.
Japonica (or anyone else)- of the causes you listed here, which ones are easily detectable in regular gyn visits? I wonder...
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