Worldwide, prevention of most stillbirths is possible with improved health systems. In this report by Sade Oguntola, experts say this sad reality for many families is preventable in about 60 per cent of all cases. FOR too long, pregnancy loss has been a silent grief women are expected to bear alone and it takes a serious toll on families’ health and well-being. But this devastating outcome of pregnancy; a baby growing inside its mothers suddenly, and often inexplicably dying is more common than people realize. In 2015, World Health Organisation recorded 2.6 million stillbirths globally, with more than 7,178 deaths a day. The majority of these deaths occurred in developing countries. An estimated 313,700 infants died as stillborn across Nigeria in 2015, ranking the country second after India, with some 592,100 stillbirths, according to a study report by Lancet. Unfortunately, the stillbirth rate in sub-Saharan Africa is approximately 10 times that of developed countries. “Ironically, over 60 per cent of these deaths were preventable,” said Dr Sesan Oluwasola, a consultant obstetrics and gynaecologist at the University College Hospital (UCH), Ibadan, said. A stillbirth is the death or loss of a baby before or during delivery. Both miscarriage and stillbirth describe pregnancy loss, but they differ according to when the loss occurs. In Nigeria, a stillbirth is the death of a baby during pregnancy before the age of viability that Dr Oluwasola puts at after 28 completed pregnancy weeks. “Most women lose their babies at about 25 completed pregnancy weeks, what many people refer to as a miscarriage, “he added. The causes of many stillbirths are unknown. But known contributors to stillbirth include problems with the baby (birth defects or genetic problems); problems with the placenta or umbilical cord and certain conditions in the mother such as an infection like malaria, uncontrolled diabetes, high blood pressure, anaemia, and obesity. Others include genetic factors, rhesus incompatibility, the poor women’s health, age, drug use, and lifestyles such as obesity, heavy drinking, and smoking. Following a stillbirth, women are at higher risk of another one; however, most subsequent pregnancies do not have similar problems. Problems with the placenta, what is medically termed placental insufficiency, are thought to be the most common cause of a baby dying in the womb. About two-thirds of babies who die in the womb are thought to be lost because of placental insufficiency. According to Dr Oluwasola, “In some cases, babies could have their umbilical cord twinning on themselves or form a knot. When the cord gets strangulated, it can cause cord accident. It is one of the common causes of a baby dying in the womb.” Cord accidents do occur when, for example, there is too much amniotic fluid and then as the baby is swimming around; it twinned the cord around it. Also, if the cord is short, the baby can probably pull the cord around his neck. The exact reasons why the placenta may not work properly are not fully understood. But doctors do know that if the placenta is not working well, the blood vessels that connect the mother to her baby become constricted. The expert declared that some women also end up losing their babies due to cervical incompetence and severe anaemia in pregnancy, adding also that where there is a rhesus incompatibility and the mother has not been immunised earlier, her baby may also die in the womb. Nonetheless, Dr Oluwasola said although stillbirth occurs in families of all races, ethnicities, and income levels, and to women of all ages, some women are at higher risk of having a stillbirth.
Published by Transcon Healthcare Ltd

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