Noel, L; Coutinho, CM; Thilaganathan, B
(2022)
Preventing Stillbirth: A Review of Screening and Prevention Strategies.
MATERNAL-FETAL MEDICINE, 4 (3).
pp. 218-228.
ISSN 2096-6954
https://doi.org/10.1097/FM9.0000000000000160
SGUL Authors: Thilaganathan, Baskaran
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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.
Item Type: | Article | ||||||||
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Additional Information: | Copyright © 2022 The Chinese Medical Association, published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. | ||||||||
Keywords: | Biomarkers, Fetal growth restriction, Placental dysfunction, Prevention, Screening, Stillbirth | ||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) | ||||||||
Journal or Publication Title: | MATERNAL-FETAL MEDICINE | ||||||||
ISSN: | 2096-6954 | ||||||||
Dates: |
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Publisher License: | Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0 | ||||||||
Web of Science ID: | WOS:000828954400009 | ||||||||
URI: | https://openaccess.sgul.ac.uk/id/eprint/114839 | ||||||||
Publisher's version: | https://doi.org/10.1097/FM9.0000000000000160 |
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