Preventing Stillbirth: A Review of Screening and Prevention Strategies
Abstract. Stillbirth is a devastating pregnancy complication that still affects many women, particularly from low and middle-income countries. It is often labeled as “unexplained” and therefore unpreventable, despite the knowledge that placental dysfunction has been identified as a leading cause of...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Health
2022-07-01
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| Series: | Maternal-Fetal Medicine |
| Online Access: | http://journals.lww.com/10.1097/FM9.0000000000000160 |
| _version_ | 1817971226338918400 |
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| author | Laure Noël Conrado Milani Coutinho Basky Thilaganathan Yiyuan Jiang Dandan Shi |
| author_facet | Laure Noël Conrado Milani Coutinho Basky Thilaganathan Yiyuan Jiang Dandan Shi |
| author_sort | Laure Noël |
| collection | DOAJ |
| description | Abstract. Stillbirth is a devastating pregnancy complication that still affects many women, particularly from low and middle-income countries. It is often labeled as “unexplained” and therefore unpreventable, despite the knowledge that placental dysfunction has been identified as a leading cause of antepartum stillbirth. Currently, screening for pregnancies at high-risk for placental dysfunction relies on checklists of maternal risk factors and serial measurement of symphyseal-fundal height to identify small for gestational age fetuses. More recently, the first-trimester combined screening algorithm developed by the Fetal Medicine Foundation has emerged as a better tool to predict and prevent early-onset placental dysfunction and its main outcomes of preterm preeclampsia, fetal growth restriction and stillbirth by the appropriate use of Aspirin therapy, serial growth scans and induction of labour from 40 weeks for women identified at high-risk by such screening. There is currently no equivalent to predict and prevent late-onset placental dysfunction, although algorithms combining an ultrasound-based estimation of fetal weight, assessment of maternal and fetal Doppler indices, and maternal serum biomarkers show promise as emerging new screening tools to optimize pregnancy monitoring and timing of delivery to prevent stillbirth. In this review we discuss the strategies to predict and prevent stillbirths based on first-trimester screening as well as fetal growth and wellbeing assessment in the second and third trimesters. |
| first_indexed | 2024-04-13T20:43:56Z |
| format | Article |
| id | doaj.art-fd852ede1d9e42af975e361064f8577b |
| institution | Directory Open Access Journal |
| issn | 2641-5895 |
| language | English |
| last_indexed | 2024-04-13T20:43:56Z |
| publishDate | 2022-07-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Maternal-Fetal Medicine |
| spelling | doaj.art-fd852ede1d9e42af975e361064f8577b2022-12-22T02:30:47ZengWolters Kluwer HealthMaternal-Fetal Medicine2641-58952022-07-014321822810.1097/FM9.0000000000000160202207000-00009Preventing Stillbirth: A Review of Screening and Prevention StrategiesLaure NoëlConrado Milani CoutinhoBasky ThilaganathanYiyuan JiangDandan ShiAbstract. Stillbirth is a devastating pregnancy complication that still affects many women, particularly from low and middle-income countries. It is often labeled as “unexplained” and therefore unpreventable, despite the knowledge that placental dysfunction has been identified as a leading cause of antepartum stillbirth. Currently, screening for pregnancies at high-risk for placental dysfunction relies on checklists of maternal risk factors and serial measurement of symphyseal-fundal height to identify small for gestational age fetuses. More recently, the first-trimester combined screening algorithm developed by the Fetal Medicine Foundation has emerged as a better tool to predict and prevent early-onset placental dysfunction and its main outcomes of preterm preeclampsia, fetal growth restriction and stillbirth by the appropriate use of Aspirin therapy, serial growth scans and induction of labour from 40 weeks for women identified at high-risk by such screening. There is currently no equivalent to predict and prevent late-onset placental dysfunction, although algorithms combining an ultrasound-based estimation of fetal weight, assessment of maternal and fetal Doppler indices, and maternal serum biomarkers show promise as emerging new screening tools to optimize pregnancy monitoring and timing of delivery to prevent stillbirth. In this review we discuss the strategies to predict and prevent stillbirths based on first-trimester screening as well as fetal growth and wellbeing assessment in the second and third trimesters.http://journals.lww.com/10.1097/FM9.0000000000000160 |
| spellingShingle | Laure Noël Conrado Milani Coutinho Basky Thilaganathan Yiyuan Jiang Dandan Shi Preventing Stillbirth: A Review of Screening and Prevention Strategies Maternal-Fetal Medicine |
| title | Preventing Stillbirth: A Review of Screening and Prevention Strategies |
| title_full | Preventing Stillbirth: A Review of Screening and Prevention Strategies |
| title_fullStr | Preventing Stillbirth: A Review of Screening and Prevention Strategies |
| title_full_unstemmed | Preventing Stillbirth: A Review of Screening and Prevention Strategies |
| title_short | Preventing Stillbirth: A Review of Screening and Prevention Strategies |
| title_sort | preventing stillbirth a review of screening and prevention strategies |
| url | http://journals.lww.com/10.1097/FM9.0000000000000160 |
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