Stillbirth of a Child

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

[Keith Downing, MD]

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

[trustandobey11]

I am so sorry for your loss and i thought i might pass along some information/personal experience. My first daughter was also stillborn unexpectley during what i thought was a "normal" pregnancy. When i was 30 weeks pg i didn't feel any fetal movement and went to the doctor and they couldn't find a heartbeat. I was induced and gave birth to a very small little girl on 7/28/05. She was 1.9 oz...The autopsy could not figure out why she had died leaving me with alot of questions. Then in 2006 i got pregnant again and my new doctor ran some blood tests discovering that i have a rare blood clotting disorder which he believes caused my first baby to die in utero. For my second pregnancy i gave myself injectins 2x a day with a blood thinner called Heparin (to prevent any blood clots from occuring) and in may 2006 i gave birth to a beautiful, healthy child. So i would definitley have the blood clotting blood work ran to see if you have that. If you do then something as simple as heparin shots could save your next baby. It is totally worth it! good luck and God bless

[KC99]

I have recently lost my baby to true knots.My due date was 19 aug - on 15 aug Ifelt no movemets at all. When I reaced the hospital they could not get his heartbeat.
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

[Emma23]

Well, what can I say??
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

[renimc]

My daughter in-law had a still born baby monday.  She had a healthy pregnancy. She felt the baby moving all of sunday night, more than usual.  She started to have labor pains after taking percocet.  The baby is 7 pounds.  Fully formed.  The only thing I noticed was that his first layer of skin was peeled of on most of his body, leaving most of him bright neon red.  What is that?  Could the percocet have caused his death.  She was also given strong doses of amoxicillan.

[renimc]

She was fiven the amoxicillan for a cyst on her labia

[renimc]

[JLH05]

I'm so sorry about the loss of your baby. I too had a stillborn baby. He was 27 weeks and I hadn't felt him move so I went in. They couldn't find a heartbeat. I was induced the next day and had him 2 days later. My pregnancy was very uneventful as well. They believe it was caused by the placenta- something was "wrong" with it and eventually couldn't support him.

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!

[Mscookie]

Thany you for your kind words.

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.

[trustandobey11]

I just read your last comment about being diagnosed with the Factor V Leiden and wanted to let you know that I have the exact same condition and as you can see from my earlier comment i also had a stillborn child in my first pregnancy and after being diagnosed with the Factor V Leiden I took the blood thinner Heparin in my second pregnancy and i now have a healthy, beautiful 16 month old little girl. So you should know that the blood thinner is a very effective treatment and your next pregnancy should go very smoothly. Good luck and God bless!

[Bibi12]

A related discussion, pregnancy was started.