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Stillbirth Can Be Devastating, Unpredictable
Date:10/26/2010

llbirths earlier than 32 weeks are often similar to those that raise the risk of premature birth: smoking, alcohol use, obesity, clotting or metabolic problems and kidney or liver disease in the mother, Fleischman said.

During the final weeks of pregnancy, stillbirth is often due to a catastrophic problem with the placenta or the umbilical cord, including placental abruption, when the placenta sheers off the uterine wall, leaving the baby without oxygen and nutrients.

Little can be done to prevent these types of stillbirths, Fleischman said. But some obstetricians recommend mothers "count kicks" at the same time every day to monitor how often the fetus moves. If movement drops off noticeably, mothers should seek medical attention in the hopes of delivering a baby in distress before it's too late.

Much of Heazell's research focuses on what goes wrong with the placenta. Often, an examination of the placenta after a stillbirth shows signs of reduced blood flow or abnormal aging. "A placenta is a bit of a record of pregnancy," he said. "If we can understand what goes wrong, we might be able to stop more stillbirths."

If the placenta has deteriorated, the fetus will stop moving to conserve energy, Heazell said. "We think there's a small window of opportunity, maybe between 24 and 48 hours, for some," Heazell said.

His travels have recently taken him to a meeting of the International Federation of Placenta Associations in Santiago, Chile, and an International Stillbirth Alliance conference in Australia.

For several years, on the anniversary of the pregnancy loss, Heazell would take time off from work to grieve and be alone. Unlike grief associated with other deaths, grieving for a stillborn baby can be isolating. Families don't share in the loss because they hadn't yet grown attached to the baby.

The magnitude of the problem and the emotional impact it can have on couples justify more research into preventing it, Heazell sai
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