The presence of risk factors for stillbirth
Previously reported and common risk factors for stillbirth were present within our cohort. 26% of mothers were anaemic (haemoglobin <100 g/L), however, haemoglobin levels were only recorded in 56% of total cases and information regarding timing of haemoglobin testing was not available in most records. The median haemoglobin was 108 g/L for these women. 52 women were not tested for syphilis. Of the 90 women who were tested for syphilis, 25% were positive (n=23/90) and only seven of these women completed treatment. Only 2 case files had documentation of partner treatment. Sixteen women (11%) had experienced a prior stillbirth. The majority of mothers had at least one antenatal visit prior to their stillbirth (78%). 20% were obese (body mass index>30), however body mass index was only recorded for 47% of the cases. All but one mother received an ultrasound during the course of her care, however only 25% received an ultrasound in the first or second trimester. Reduced fetal movements were reported prior to attendance in 67 cases (47%). Discussion of common danger signs, such as reduced fetal movements or vaginal bleeding, were not documented for 50% of cases.
Most women had a spontaneous vaginal birth (83%). There were seven inductions, two instrumental births and 14 emergency caesarean sections (two of which were failed inductions). Birthweight was not documented for 18 stillbirths. Of those with a recorded birthweight, low birthweight (<2500g) was present in 59% of cases, with a median birthweight of 1920g (range 500g to 4984g, IQR 1668.5g) and 32% extremely low birthweight (<1500g).