Women's expectations of management in their next pregnancy after an unexplained stillbirth: an Internet-based empirical study.
BACKGROUND
Unexplained stillbirth is the largest contributor to perinatal death, accounting for one-third of stillbirths. There appears to be no increase in perinatal death rates in the pregnancies that follow an unexplained stillbirth. However, these pregnancies have increased rates of induced labour and elective caesarean section, as well as preterm birth, low birthweight, instrumental delivery, 'fetal distress' and postpartum haemorrhage.


OBJECTIVE
To study the wishes for future pregnancy management in women who have suffered an unexplained stillbirth.


METHODS
An Internet-based survey of women after an unexplained stillbirth, seeking demographic information and reproductive history, details of management of the index stillbirth and information about their wishes for subsequent pregnancy management (antenatal surveillance, early delivery and caesarean delivery).


RESULTS
Of the total respondents included in the study, 93% wanted 'testing' over and above normal pregnancy care in their next pregnancy. Of the respondents, 81% wanted early delivery and 26% wanted a Caesarean delivery, irrespective of obstetric indications. These wishes were not influenced by socio-demographic factors, management of the index stillbirth (with the exception of having had a Caesarean delivery) or advice received on management of the next pregnancy (with the exception of being advised to have an early or Caesarean delivery).


CONCLUSIONS
The women surveyed wanted increased fetal surveillance and early delivery, but not necessarily elective caesarean section.
Robson
Stephen J
SJ
Australian National University Medical School, Canberra, Australian Capital Territory, Australia. steve.robson@act.gov.au
Leader
Leo R
LR
Dear
Keith B G
KB
Bennett
Michael J
MJ
D000328:Adult; D002585:Cesarean Section; D015331:Cohort Studies; D005260:Female; D005323:Fetal Monitoring; D019538:Health Care Surveys; D006801:Humans; D020407:Internet; D007751:Labor, Induced; D057240:Patient Preference; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D011295:Prenatal Care; D050497:Stillbirth / Q000523:psychology*; D055815:Young Adult