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Fetal death it is a terribly disconcerting situation for the mother, family members and healthcare professionals. There have been numerous studies that try to find the cause of this situation in order to identify and prevent it.
In developed countries 1 out of every 160 babies is stillborn, or their heartbeat ceases in the last trimester of pregnancy; which is a very painful situation for parents and not so uncommon.
There is much controversy to define stillbirth, since there is no unanimous agreement; However, we can say that fetal death occurs when there is no heartbeat in a fetus weighing more than 500 grams and / or with more than 20 weeks of gestation. In cases where it occurs before the 20th week or the one weighing less than 500 grams, abortion is spoken of.
Many times it is very difficult to find the cause of death before birth, however we will analyze some risk factors associated with the mother, the fetus and / or the placenta.
1. Prolonged pregnancy (more than 42 weeks).
2. Chronic diseases of the mother such as diabetes mellitus (uncontrolled), lupus erythematosus, high blood pressure or some blood problem with clot formation that contribute to poor growth of the baby and the detachment of the placenta. All this in uncontrolled pregnancies.
3. Infections during pregnancy such as listeriosis, salmonella, rubella or toxoplasmosis.
4. Preeclampsia and eclampsia: which can reduce blood flow to the baby. This condition is associated with detachment of the placenta.
5. Very early or advanced maternal age.
6. Any problem at the time of delivery related to the position of presentation of the baby.
7. Rh incompatibility (Rh in maternal blood is different from Rh in baby).
8. Uterine rupture.
9. Severe maternal hypotension (that is, a very significant drop in the mother's blood pressure), associated with uncontrolled bleeding or serious illness.
10. Maternal death.
1. Multiple gestation (of two or more babies).
2. CIUR (retarded uterine growth): Babies who grow very slowly have an increased risk of dying during pregnancy.
3. Congenital or genetic abnormalities: a physical or genetic defect in the baby. Multiple malformations in babies can be genetic, environmental or unknown causes and it will always be important to consult a genetic specialist in cases of babies who die in these circumstances.
4. Between 5 and 10 percent of babies born still have abnormalities related to their chromosomes, which are the structures that contain the genetic material that determines our physical characteristics. Especially in losses before week 20, chromosome abnormalities are particularly frequent, although they can cause the death of the fetus at any time during pregnancy.
5. Infections Bacterial infections affecting the fetus or the placenta are a major cause of fetal deaths that occur between 24 and 27 weeks of gestation. Sometimes a pregnant woman may have an infection that can go unnoticed (such as genital and urinary tract infections and certain viruses such as parvovirus) until it has caused serious complications, such as the death of the fetus or its premature birth (formerly ending the 37th week of pregnancy).
6. After delivery, it is possible to show whether the death of the fetus was caused by a bacterial infection by performing special tests on the placenta.
1. Umbilical cord accidents (such as knots or crushing).
2. Abrupt placenta (detachment of the placenta during pregnancy).
3. The placenta is a vital organ for maintaining the health of the baby. Placental abruption, a disorder in which the placenta separates from the uterus, partially to almost completely, occurs most often around the 35th week of pregnancy. This disorder causes significant bleeding that prevents the fetus from receiving the adequate amount of oxygen and can lead to death. Ultrasound can diagnose placental abruption, if it is detected early, an urgent cesarean section should be performed, which can save the baby's life. Women who smoke or use cocaine are at higher risk of detachment.
4. Severe aging of the placenta, the formation of placental clots are other problems that prevent the fetus from receiving enough oxygen and nutrients also contribute to the death of the fetus. This is controlled by ultrasound.
5. Premature membrane rupture (the bag of waters breaks before the appropriate time). If it is not diagnosed, there may be an elevated risk of infection.
6. Vasa previa (an obstetric complication in which fetal blood vessels that are not protected by the cord cross or run very close to the opening of the cervix and can easily tear when the cervix is dilated. The result is that the baby bleeds out).
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