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28. Stillbirth
Introduction
Stillbirth is a profoundly tragic event in any prospective parent's life. The sense of utter hopelessness is usually overwhelming. Mercifully, this is an uncommon event.

In the vast majority of cases of stillbirth, it is completely unexpected and therefore unpredictable. This obviously adds to the weight of the tragedy.
Many parents' anguish is not helped by the fact that, even after the event, extensive investigations that are carried out do not yield the important answer: the cause. This is still true in roughly half the cases of stillbirth.

Getting an explanation does at least have the effect of allowing them to try to come to terms with the loss. It also helps the doctors to give credible and informed advice about the future.

So what do we known about causes of stillbirth?
As we shall see in answers to specific questions below, the identifiable causes can be divided into three broad groups. There are maternal illnesses that are usually known before the event; examples include diabetes or pre-eclampsia. There is therefore room to institute measures to prevent this eventuality. Sometimes the measures fail.

The second group constitutes fetal problems which may include viral or bacterial infections (usually silent and unrecognised) and cord accidents. The third group is where the problem is in the placenta (afterbirth).

Any one of the mentioned potential causes of stillbirth is relatively easy to identify after the event. It is therefore possible to give informed advice to the parents.

There are many support groups which parents in this situation find very useful. Medical science has advanced to a stage where any further reduction in the rate of stillbirth is probably an unrealistic prospect. Efforts are therefore appropriately concentrated on trying to ensure that this sad event does not affect the same mother more than once.
Frequency Causes Prevention After stillbirth Recurrence Support

By Dr Joe Kabyemela, MD