Management of stillbirth delivery.
Stillbirth is a common adverse outcome of pregnancy. Management should be individualized based on gestational age, maternal condition, prior uterine surgery, availability of skilled professionals, and maternal desires. This article discusses available data on management by gestational age and prior uterine surgery. Expectant management is a viable option for women and families who desire it and do not have any contraindications. In the second trimester, misoprostol induction and dilatation and evacuation are effective in the evacuation of the uterus. In the third trimester, induction of labor with prostaglandins, mechanical dilators, and augmentation with oxytocin is appropriate. Care should be taken with women with prior cesarean delivery; prostaglandins ideally should be avoided. Delivery by cesarean section should be performed selectively, i.e., when there is a maternal indication.
Maternal and Pediatric Infectious Disease Branch, Eunice Kennedy Shriver, National Institute of Child Health and Human Development, National Institute of Health, 6100 Executive Blvd, Rm 4B11, Bethesda, MD 20892-7510 (Fed X: Rockville, MD 20852). Electronic address: Nahida.chakhtoura@nih.gov.
Nahida A
NA
Chakhtoura
Pregnancy and Perinatology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
Uma M
UM
Reddy
D000028:Abortion, Induced / Q000379:methods*; D000328:Adult; D002585:Cesarean Section / Q000379:methods*; D000075202:Contraindications; D037001:Directive Counseling; D005260:Female; D005865:Gestational Age; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage*; D009035:Mothers / Q000523:psychology*; D010120:Oxytocics / Q000008:administration & dosage*; D010121:Oxytocin / Q000008:administration & dosage*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D011453:Prostaglandins / Q000008:administration & dosage; D050497:Stillbirth / Q000523:psychology; D013997:Time Factors; D014546:Urinary Catheterization / Q000379:methods; D016064:Vaginal Birth after Cesarean
D010120:Oxytocics; D011453:Prostaglandins; D016595:Misoprostol; D010121:Oxytocin
intrauterine fetal death; management; pregnancy; stillbirth