gynecology and obstetrics
Stillbirth
Treatment of Stillbirth
Uterine evacuation if required Routine postdelivery care Emotional support Uterine evacuation may have spontaneously occurred. If not, evacuation should be done using drugs (eg,oxytocin) or a surgical procedure (eg, dilation and evacuation [D & E], preceded by preabortion osmotic dilators to prepare the cervix, with or withoutmisoprostol), depending on the gestational age. After the products of conception are expelled, curettage may be needed to remove any retained placental fragments. Fragments are more likely to remain when stillbirth occurs very early in the pregnancy. If DIC develops, coagulopathy should be promptly and aggressively managed by replacing blood or blood products as needed. Postdelivery management is similar to that for live birth. Parents typically feel significant grief and require emotional support and sometimes require formal counseling. Risks with future pregnancies, which are related to the presumed cause, should be discussed with patients. 