stillbirth
Introduction
Introduction After 20 weeks of gestation, the fetus dies in the womb, called the stillbirth. Since about half of the stillbirth cases have no signs at all during pregnancy, most parents lose their fetus without being aware of it. Within two weeks of the death of the fetus, it is generally possible to give birth naturally. Choosing to wait for the natural delivery is not a great risk to the health of the pregnant woman. If the pregnant woman chooses to wait for the natural delivery, but there is still no movement after two weeks, it is best to artificially induce labor, because there is a risk of blood clotting for a long time.
Cause
Cause
Common factors are:
1. Serious fetal malformations: stillbirths or structural abnormalities caused by hereditary or environmental factors or unknown factors.
2, pregnant women's high blood pressure conditions cause the fetus can not get enough nutrients and oxygen supply.
3, high blood pressure caused by pregnancy ecstasy (eclampsia), causing death of pregnant women and fetuses.
4. Before the delivery, the placenta is partially or completely exfoliated early, and the fetus is deprived of oxygen due to excessive blood loss from the mother. The situation can endanger the life of the mother and the fetus.
5, fetal growth is limited, too small or slow-growing fetuses have to face higher suffocation (hypoxia) or unknown factors regardless of prenatal or bifurcation.
6. Pregnant women with high blood pressure are also more likely to give birth to infants with slow growth.
7, premature rupture of the membranes cause intrauterine infection.
8, Mediterranean type? Blood (thalassemi) or Rhesus factor (Rhesus factor) disease.
9. Undetected or poorly controlled gestational diabetes.
10. Bacterial infection. Toxoplasmosis, Group B Streptococcus, and German measles are important causes of fetal death between 24 and 27 weeks. This type of infection has no symptoms and pregnant women may be unaware. Check the placenta of the stillbirth to see if it died of a bacterial infection.
Examine
an examination
Related inspection
Fetal heart sound
X-ray inspection
In the early stage of fetal death, X-ray examination can be found without any abnormality. After the fetal deformation, there are four main X-ray signs in the abdomen, and the formation of gas by fetal blood decomposition is the only reliable. X-ray diagnosis signs:
(1) Gas formation This phenomenon occurs 6 hours to 10 days after the death of the fetus, and the gas is accumulated in the fetal large blood vessels or soft tissues, and this phenomenon occurs in most cases. Gas formation occurs only in late fetal deaths and can sometimes be mistaken for excessive gas accumulation by the mother, and diagnosis may be difficult.
(2) The halo around the fetal head is the first sign of fetal death within 48 hours. Due to the accumulation of fetal cap-like subdural fluid, the scalp lower fat is formed by halo, which may occur in most cases, but sometimes it must be differentiated from fetal edema.
(3) The collapse of the fetal cranial plate often appeared after 7 days of death, and almost 10 days later, the skull plate collapsed. It is mainly caused by the reduction of intracranial pressure after fetal death, resulting in deformation of the skull.
(4) Spine angle phenomenon After the death of the fetus, the spinal cord tension is weakened or disappeared, and a backward angulation phenomenon occurs.
2. Ultrasound examination
The fetal death time is different, and the ultrasound examination is different.
Diagnosis
Differential diagnosis
Clinically, it is mainly identified with abortion. The main symptoms of abortion are vaginal bleeding and abdominal pain. Vaginal bleeding occurs in abortion within 12 weeks of gestation. At the beginning, the villus is separated from the aponeurosis, and the sinusoids are open, that is, bleeding begins. When the embryo is completely separated and discharged, the bleeding stops due to contraction of the uterus. The whole process of early abortion is accompanied by vaginal bleeding. In the late abortion, the placenta has formed. The abortion process is similar to that of premature delivery. The placenta is discharged after the delivery of the fetus. Generally, there is not much bleeding. The characteristic is that there is often abdominal pain first, followed by vaginal bleeding. Late abortion is preceded by paroxysmal uterine contractions, and then the placenta is stripped, so vaginal bleeding occurs after abdominal pain. Check the size of the uterus during abortion, whether the cervix is dilated, and whether the membrane is broken, depending on the number of weeks of pregnancy and the process of abortion.
