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Subsequent pregnancy after stillbirth: obstetrical and medical risks

  • Keren Ofir , Anat Kalter , Orit Moran , Eyal Sivan , Eyal Schiff und Michal J. Simchen EMAIL logo
Veröffentlicht/Copyright: 11. April 2013
Journal of Perinatal Medicine
Aus der Zeitschrift Journal of Perinatal Medicine Band 41 Heft 5

Abstract

Objective: To evaluate obstetric outcome after stillbirth according to placental and prothrombotic risk factors.

Methods: Obstetric outcomes of women with prior stillbirth and subsequent pregnancies were reviewed. Data on the immediate subsequent pregnancy included fetal loss, stillbirth, obstetric/medical complications, gestational age and birth weight at delivery, mode of delivery, thrombophilia, and prescribed medication. Placental stillbirth was defined as stillbirth associated with placental abruption, intrauterine growth restriction (IUGR), or histological evidence of placental infarcts. Controls were unselected women who gave birth at our center during a single calendar year. Factors influencing recurrence risks were estimated.

Results: Seventy-three subsequent pregnancies were identified. Five out of 73 (6.8%) women had a repeat stillbirth, significantly higher than controls (relative risk 22.2, 95% confidence interval 8.9–55.4). Four out of five repeat stillbirth cases occurred <37 weeks gestation. Hypertensive complications, diabetes and abruption were higher, while gestational age and birth weight at delivery were significantly lower than controls. Prior placental stillbirth was associated with a 10.5 times higher risk of IUGR in the subsequent pregnancy compared with non-placental stillbirth. All five repeat stillbirth cases occurred in thrombophilic women.

Conclusion: Women with prior stillbirth face an increased risk of pregnancy complications and stillbirth recurrence, especially with concurrent thrombophilia. Most repeat stillbirth cases occur preterm.

Keywords: IUFD; placental stillbirth; pregnancy after IUFD; pregnancy after stillbirth; stillbirth; thrombophilia pregnancy complications
Corresponding author: Michal J. Simchen, MD, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, 52621, Israel, Tel.: +972-3-5302169, Fax: +972-3-5302922

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The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2013-1-20
Accepted: 2013-3-15
Published Online: 2013-04-11
Published in Print: 2013-09-01

©2013 by Walter de Gruyter Berlin Boston

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https://doi.org/10.1515/jpm-2013-0013
Schlagwörter für diesen Artikel
IUFD; placental stillbirth; pregnancy after IUFD; pregnancy after stillbirth; stillbirth; thrombophilia pregnancy complications

Artikel in diesem Heft

  1. Masthead
  2. Masthead
  3. Review Article
  4. Is 5-methyltetrahydrofolate an alternative to folic acid for the prevention of neural tube defects?
  5. Original Articles – Obstetrics
  6. Differences and similarities in the transcriptional profile of peripheral whole blood in early and late-onset preeclampsia: insights into the molecular basis of the phenotype of preeclampsiaa
  7. The correlation of ultrasonographic placental architecture with placental histology in the low-risk primigravid population
  8. The course of angiogenic factors in early- vs. late-onset preeclampsia and HELLP syndrome
  9. Effect of maternal body mass index on oxytocin treatment for arrest of dilatation1)
  10. Maternal weight gain in women with gestational diabetes mellitus
  11. Clinical risk factors for complete and partial placental retention – a case-control study
  12. Diagnostic problems in case of twin pregnancies: US vs. MRI study
  13. Subsequent pregnancy after stillbirth: obstetrical and medical risks
  14. MTHFR C677T polymorphism, folate, vitamin B12 and homocysteine in recurrent pregnancy losses: a case control study among north Indian women
  15. Acupuncture and/or sweeping of the fetal membranes before induction of labor: a prospective, randomized, controlled trial
  16. First trimester maternal serum placental protein 13 levels in singleton vs. twin pregnancies with and without severe pre-eclampsia
  17. Relaparotomies after cesarean sections: risk factors, indications, and management
  18. The impact of route of anesthesia on maternal and fetal ischemia modified albumin levels at cesarean section: a prospective randomized study
  19. Infection and smoking are associated with decreased plasma concentration of the anti-aging protein, α-klothoa
  20. Effect of oxygen tension on bacteria-stimulated cytokine production by fetal membranes
  21. Original Articles – Fetus
  22. Is there a relationship between fetal brain function and the fetal behavioral state? A fetal MEG-study
  23. Original Articles – Newborn
  24. Infrared thermography for detailed registration of thermoregulation in premature infants
  25. Short Communication
  26. Are there gender related differences in neonatal abstinence syndrome following exposure to buprenorphine during pregnancy?
  27. Congress Calendar
  28. Congress Calendar
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