Preventing Stillbirth: Large Private Community Practice Experience
Dr. Boris Petrikovsky, Dr. Michael Terrani, Dr. Catherine Frankowski-Szymczak, and Victoria Gardner, PA-C, from Garden OBGYN, delve into the causes, prevention strategies, and support mechanisms for families affected by stillbirth. Explore insights into fetal testing, the Rainbow Stillbirth Clinic, the Stillbirth Collaborative Network, and mental health support, offering a comprehensive perspective on addressing this complex challenge in obstetric care.
Stillbirth, a devastating reality affecting thousands of families annually, remains a significant concern in obstetric care. In a collaborative effort, Dr. Boris Petrikovsky, Dr. Michael Terrani, Dr. Catherine Frankowski-Szymczak, and Victoria Gardner, PA-C, from Garden OBGYN, shed light on the causes, prevention strategies, and support mechanisms for families affected by stillbirth.
Understanding the Causes:
Stillbirth often occurs in pregnancies with identifiable risk factors such as nulliparity, advanced maternal age, diabetes, chronic hypertension, and smoking. Obesity and in vitro fertilization (IVF) pregnancies also contribute to an increased risk. However, many cases occur without identifiable risk factors, highlighting the complexity of the condition.
Recent research underscores premature placental aging as a significant factor in stillbirth cases. Placental abnormalities, including thickening of maternal spiral artery walls, infarcts, and vascular occlusion, are common findings. These abnormalities, categorized as acute and chronic placental dysfunction, contribute to stillbirth occurrences.
Fetal Testing and Prevention:
Fetal testing, including non-stress tests (NST), biophysical profiles (BPP), and oxytocin challenge tests (OCT), plays a crucial role in stillbirth prevention. Abnormal results may indicate placental dysfunction, necessitating closer monitoring and intervention. Stallmach et al. proposed abnormal placental maturation and dysfunction as major preventable causes, emphasizing the urgency of targeted interventions.
The Rainbow Stillbirth Clinic:
The Rainbow Clinic, pioneered by Dr. Alex Heazell, offers specialized care for families affected by stillbirth. Through additional testing and emotional support, the clinic focuses on early detection of fetal growth restriction and placental dysfunction. The multidisciplinary approach addresses the emotional and medical aspects of stillbirth, aiding in the healing process for families.
The Stillbirth Collaborative Network (SCRN):
The SCRN emphasizes the preventability of stillbirth, targeting common causes such as placental insufficiency and maternal complications. By developing tailored strategies for risk assessment and intervention, obstetric practices can significantly reduce stillbirth rates within their patient populations.
Support and Mental Health:
The impact of stillbirth extends beyond medical implications, profoundly affecting maternal mental health. Caregivers play a crucial role in providing emotional support and facilitating personalized grieving processes. Access to support groups and comprehensive psychosocial care is essential for coping and healing.
Conclusion:
Stillbirth remains a complex challenge in obstetric care, requiring a multifaceted approach encompassing prevention, specialized care, and ongoing support. By addressing risk factors, implementing targeted interventions, and prioritizing emotional well-being, healthcare providers can strive towards reducing the prevalence of stillbirth and providing compassionate care to affected families. The authors, Dr. Boris Petrikovsky, Dr. Michael Terrani, Dr. Catherine Frankowski-Szymczak, and Victoria Gardner, PA-C, emphasize the importance of collaborative efforts in addressing this critical issue within obstetric practice.
