Prediction and Prevention of Recurrent Stillbirth
- 1 November 2007
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Obstetrics & Gynecology
- Vol. 110 (5), 1151-1164
- https://doi.org/10.1097/01.aog.0000287616.71602.d0
Abstract
Stillbirth is one of the most common adverse pregnancy outcomes in the United States, occurring in one out of every 200 pregnancies. There is a paucity of information on the outcome of pregnancies after stillbirth. Prior stillbirth is associated with a twofold to 10-fold increased risk of stillbirth in the future pregnancy. The risk depends on the etiology of the prior stillbirth, presence of fetal growth restriction, gestational age of the prior stillbirth, and race. Categorization of the cause of the initial stillbirth will allow better estimates of individual recurrence risk and guide management. A history of stillbirth also increases the risk of other adverse pregnancy outcomes in the subsequent pregnancy such as placental abruption, cesarean delivery, preterm delivery, and low birth weight infants. Prospective studies have revealed an increased risk of stillbirth with low pregnancy-associated plasma protein A, elevated maternal serum alpha fetoprotein, abnormal uterine artery Doppler studies, and antiphospholipid antibodies. However, the positive predictive value of these factors individually is poor. Because fetal growth restriction is associated with almost half of all stillbirths, the correct diagnosis of fetal growth restriction is essential. The use of individualized or customized growth standards will improve prediction of adverse pregnancy outcome by distinguishing growth-restricted fetuses from constitutionally small, healthy fetuses. Antepartum fetal surveillance and fetal movement counting are also mainstays of poststillbirth pregnancy management.Keywords
This publication has 56 references indexed in Scilit:
- The influence of maternal smoking habits on the risk of subsequent stillbirth: is there a causal relation?BJOG: An International Journal of Obstetrics and Gynaecology, 2007
- ACOG Practice Bulletin #58: Ultrasonography in PregnancyObstetrics & Gynecology, 2004
- First-trimester maternal serum PAPP-A and free-beta subunit human chorionic gonadotropin concentrations and nuchal translucency are associated with obstetric complications: A population-based screening study (The FASTER Trial)American Journal of Obstetrics and Gynecology, 2004
- A kick from within – fetal movement counting and the cancelled progress in antenatal carejpme, 2004
- ACOG practice bulletinInternational Journal of Gynecology & Obstetrics, 2001
- Antiphospholipid antibodies and fetal deathObstetrics & Gynecology, 1996
- Prognostic significance of unexplained elevated amniotic fluid alpha-fetoproteinObstetrics & Gynecology, 1996
- Adverse Pregnancy Outcome After a False-Positive Screen for Down Syndrome Using Multiple MarkersObstetrics & Gynecology, 1995
- Antepartum surveillance for a history of stillbirth: When to begin?American Journal of Obstetrics and Gynecology, 1995
- Past obstetric history and risk of perinatal death in JamaicaPaediatric and Perinatal Epidemiology, 1994