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Pregnancy (Expert Forum)
Stillbirth of a Child
Answered by
Keith Downing, MD - Obstetrics, Gynecology
MA
This forum is for questions and support regarding pregnancy issues such as: Alcohol/Drugs, Bleeding, Caesarean Section, Childbirth, Diabetes, Depression, Fetal Monitoring, Genetic Testing, Hormonal Changes, Labor, Lamaze, Morning Sickness, Nutrition, Parenting, Prenatal Care, Weight gain.
Stillbirth of a Child
by Mscookie, Aug 04, 2007 12:00AM
I'm currently 5weeks Postpartum. Unfortunately my child was stillborn at 38weeks after no fetal heartbeat was found at a routine examination. There was a knot in the umbilical cord after he was born and some placental blood clotting. My pregnancy was uneventful, no high blood pressure, no diabetes, no bleeding. The baby was 1.9kg and 50cms long, interuterine growth restriction I'm guessing. They have taken some blood to rule out clotting disorders (which I'm sure I don't have). I would like to ask though:
1. What are some other possible causes of Placental Clotting if you don't have Auto-Immune diseases.
2. Would the knot have played a role in the IUGR factor along with the clotting.
3. Is it possible for the Placenta to seperate causing the clotting without you experiencing a bleed?
4. I stopped my Lochia at 3 weeks PP and have started lightly bleeding again (just like when my Menses used start before I was PG) could they have come back so soon?
Thanking you in advance for your reply
1. What are some other possible causes of Placental Clotting if you don't have Auto-Immune diseases.
2. Would the knot have played a role in the IUGR factor along with the clotting.
3. Is it possible for the Placenta to seperate causing the clotting without you experiencing a bleed?
4. I stopped my Lochia at 3 weeks PP and have started lightly bleeding again (just like when my Menses used start before I was PG) could they have come back so soon?
Thanking you in advance for your reply
Doctor's Answer
by Keith Downing, MD, Aug 06, 2007 12:00AM
, Aug 06, 2007 12:00AM
Hello,
My condolensces to you and your family for your loss.
Fetal death of a growth-restricted fetus is the second most common type of stillbirth. Placental dysfunction is the presumed cause of both the growth restriction and the fetal death.
It will be important for you to know that conditions resulting in placental dysfunction can be recurrent, but the placental complications may manifest in different ways in different pregnancies. Growth restriction, preterm delivery, and stillbirth can all be sequelae of impaired placental function.
With respect to your questions:
1. Etiologies of placental clotting are likely to be an inherited hypercoagulability disorder that is undiagnosed (e.g., factor V leiden deficiency or prothrombin G20210A mutation) or an acquired one (e.g., anti-phospholipid antibodies). It sounds like you have been appropriately screened for both inherited and acquired hypercoagulability disorders.
2. Cord knots are very common. It is highly unlikely the knot played a role in the death of your baby.
3. A placental abruption may have played a role in the death of your baby. However, it still remains important to determine the underlying cause of the abruption. The pathologist, who studied the placenta, likely provided some insight into this in their pathology report.
4. Yes, it sounds like your menses has returned.
Again, my sincerest condolensces and best wishes during your grieving and recovery.
Dr. Downing
My condolensces to you and your family for your loss.
Fetal death of a growth-restricted fetus is the second most common type of stillbirth. Placental dysfunction is the presumed cause of both the growth restriction and the fetal death.
It will be important for you to know that conditions resulting in placental dysfunction can be recurrent, but the placental complications may manifest in different ways in different pregnancies. Growth restriction, preterm delivery, and stillbirth can all be sequelae of impaired placental function.
With respect to your questions:
1. Etiologies of placental clotting are likely to be an inherited hypercoagulability disorder that is undiagnosed (e.g., factor V leiden deficiency or prothrombin G20210A mutation) or an acquired one (e.g., anti-phospholipid antibodies). It sounds like you have been appropriately screened for both inherited and acquired hypercoagulability disorders.
2. Cord knots are very common. It is highly unlikely the knot played a role in the death of your baby.
3. A placental abruption may have played a role in the death of your baby. However, it still remains important to determine the underlying cause of the abruption. The pathologist, who studied the placenta, likely provided some insight into this in their pathology report.
4. Yes, it sounds like your menses has returned.
Again, my sincerest condolensces and best wishes during your grieving and recovery.
Dr. Downing
After inducing pains for 2 days I managed to deliver on 18 aug.I saw the cord tightly wrapped around his ankle and a knot next to it.My IUD report reads teh cause as - 2 true knots- Could that be the only cause of death and is this not detectable in the earlier stages. As per my doc I have had an uneventful pregnancy and showed no symptoms.They say its a rare case. Pl advice on its chances of happening again.
K
I cannot offer any advice because I have never experienced a stillbirth. I have had 2 miscarriages and I thought that was the end of the world but just to even think what it must have been like for you all is impossible for me.
I think you are all very strong admiral ladies and I wish you all the very best of luck in the future!!!
Emma
We have gone on to have 3 more kids (5, 3 and 19 months) and are expecting another! For your peace of mind, have all the tests done your doctor suggests, especially if you would like to have more children. That will at least give you a little peace of mind. If they haven't suggested any and you don't feel comfortable with that, go to another doctor. We also did genetic testing to rule anything else out. But like us, you might get a "maybe" this is what caused it, but may never really know.
God bless you!
I did get the Genetic test results back and I do have an inherited gene mutation called Factor V Leiden. I am Heterozygous which means I have one good gene and one mutated gene. The OB has informed me that this is the likely cause of the clotting in the placenta.
The Ob was quite optimistic that my next pregnancy should be fine as this is condition is very treatable with blood thinners. I am happy to have some answers.