Dead Baby Research Articles

Trek to Triumph

I was screaming in the stairwell of my home, holding a dead baby. The air was so thick that I could barely breathe. Tears were racing down my face as her twin sister, Zola, was screeching at the top of her lungs. “WHY LORD, don't take my baby!” Every emotion, every word, and every second after that moment felt black. All the sweet memories from just eight days of being able to hold her, kiss her, and love her fell in a black pit along with the dreams I had for my life. As I looked down at my sweet Zaina, I could not help but see at that moment that we were the same—lifeless. I rode to the hospital in the front of the ambulance while EMS performed CPR on her in the back. I kept repeating “breathe baby, please, just choose to live,” hoping that she would hear me and fight for her life. As the double doors to the emergency room swung open, the doctor took one look at her, and I could tell it was not good. My knees gave out and I fell onto the floor. It was so cold. There was nothing left that I could do. As I struggled to gather the strength to pick myself up from the cold ground, I realized something: nothing that could happen to me for the rest of my life is worse than this. Nothing is worse than losing a child. This was my biggest fear, and I was staring face-to-face with it at age twenty-three.

The psychological effects of stillbirth on parents: A qualitative evidence synthesis of psychoanalytic literature.

Objective: To review and synthesize existing psychoanalytic literature on the psychological impact of stillbirth on mothers and fathers. Method: This qualitative systematic review followed, as far as possible, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Psychoanalytic Electronic Publishing Archive, the Single Case Archive, and PsycINFO (1999-2019) were searched to identify relevant articles published between 1999-2019 that report clinical material or theoretical considerations concerning the psychological effects of stillbirth on parents, as emerging during classical analytic or psychoanalytic therapy session/journey. A thematic synthesis was performed. Results: 46 articles were identified, providing data on the parents' experiences of grief and gender differences, the detrimental effects on the parental couple's relationship, the mother's identification with the dead baby, the importance for mothers to meet and care the stillborn baby, the mothers' drive for another pregnancy and the fear of further loss, the mothers' ambivalence toward subsequent pregnancy and child, the potential negative effects of unresolved bereavement on subsequent baby, and the replacement of a stillborn child. Conclusion: Our findings reveal there is some psychoanalytic literature providing insight into the psychological dynamics of parents after a stillbirth, with observations that could be used to improve psychological health care practices. One of the main therapeutic tasks was to facilitate parents to create a psychic space where they can bring to life, psychically, their lost and never- really-known stillborn baby, and to let him or her to be part of the on-going family narrative.

Incalculably Diffusive

Incalculably Diffusive

Unearthing the Hidden Tragedy

Background: Stillbirths are very traumatic events to the parents, family, and obstetricians. Although a global public health crises, it has remained relatively hidden while their devastations continue unabated in different parts of the world. We have not evaluated this tragedy in our practice environment hence the need for this paper. Methods: This is a retrospective study involving all cases of stillbirths that occurred at the Alex Ekwueme Federal University Teaching Hospital, Abakaliki, over a 3-year period, 2017–2019. The case notes were gotten and relevant information was retrieved and analyzed. Results: The prevalence of stillbirths in our centre was 16.1 per 1000 deliveries or one stillbirth in 62 deliveries. Majority of our parturients who had stillbirths 89 (81.7%) were unbooked, 43 (39.5%) had only primary education, 16 (14.7%) had no education at all, and only 10 (9.2%) had tertiary education. The leading cause of stillbirths was abruptio placenta 27 (24.8%) followed by prolonged obstructed labor 22 (21.1%), intrauterine fetal death of unknown cause 18 (16.5%), and ruptured uterus 10 (9%). Seventy-three (67%) women were delivered by spontaneous vaginal delivery while 18 (16.5%) had a caesarean section. Thirty (27.5%) women had postpartum hemorrhage. None of the dead babies had an autopsy performed on them. Conclusion: The prevalence of stillbirth in our centre is unacceptably high and majority of the causes are preventable. There is an urgent need for public enlightenment to highlight this silent tragedy and mobilize efforts toward its prevention. Carrying out autopsies on stillbirths especially those with unexplained causes will help elucidate some of the causes.

Umbilical Cord Teratoma: A Rare Case Report

The state of the stroma, blood vessels and the anatomical features of the umbilical cord are of direct diagnostic value, and various pathological changes can become the primary cause of fetal death. The frequency of umbilical cord tumors is not reliably known due to a very rare incidence: in the available literature there were reported about 19 cases.The aim of the study was to clinically and pathohistologically analyze a case of umbilical cord teratoma and to give an analytical review of recently reported cases.The material was obtained from a healthy 35-year-old woman with a third pregnancy. Combined ultrasound screening at the 20th week of pregnancy revealed a solid structure with cystic inclusions along the periphery on the umbilical cord. In the solid component, hyperechoic inclusions giving acoustic shadows were visualized; in the color Doppler imaging mode the neoplasm was avascular. A dead premature baby girl was born at 35th week. The cause of intrauterine fetal death was mechanical compression of the vessels of the umbilical cord by teratoma. Microscopic examination of the umbilical cord neoplasm in the area of the solid component demonstrated a pronounced development of the sebaceous glands, adipose tissue, myelinic nerve fibers, hair follicles; in the cystic component – epidermoid cysts. This evidenced about organismoid mature teratomas. Due to their rare incidence umbilical teratomas should be reported to better understand their pathomorphosis and impact on infant morbidity and mortality. Given the increased risk of concomitant malformations, the detection of an umbilical teratoma should be accompanied by a detailed and comprehensive examination of the newborn for additional pathologies.

Routine VDRL Test in Pregnant Women: How Justified Is It?

Background & objective: The present study was undertaken to justify the role of routine antenatal screening for syphilis using the Venereal Disease Research Laboratory (VDRL) test in Bangladeshi pregnant women.
 Methods: The study was carried out in the Department of Gynecology & Obstetrics Inpatient and Outpatient, Dhaka Medical College Hospital (DMCH) and selected Private Clinics over a period of 6 months between January 2016 to June 2016. Pregnant women attending at the above-mentioned places during the study period were the study population. A total of 371 women attending at antenatal clinic at OPD or admitted in the Inpatient Department of DMCH were consecutively included. The outcome variable was outcome of VDRL test.
 Result: In the present study, the mean age of the pregnant women was 24.3 years. In terms of occupation, housewife comprised the main bulk (78.8%). About 64% were multigravida and 60% were primipara. Of the 371 pregnant women subjected to VDRL test, only 4(1.1%) exhibited reactive. About one-third of the women had history of past abortion. Of them two-thirds had experienced abortion once. Of the aborted cases 57% were spontaneous and 43% induced. Ten percent of the women gave the history of delivering dead baby. Three-quarters of the dead babies were fresh, 22.2% had skin lesion and only one was macerated. Half of the women had history of vaginal discharge, 27.2% itching in vagina and vulva and 17% dysuria. However, very few husbands had dysuria, pus discharge through urethra or ulcer in the genital region. About 10% of women gave the history opthalmia neonatrum in their children born in the past. History of dysuria was rare (0.8%), but pus discharged from urethra of their husbands was 12.1%. HbsAg was found positive in 5(1.3%) cases and pus-cell in urine in 41(11.1%) cases.
 Conclusion: The study concluded that pregnant women with VDRL test positivity in Bangladeshi population are low and, as such, the role of routine antenatal screening for syphilis with VDRL test should be re-considered.
 Ibrahim Card Med J 2020; 10 (1&2): 89-95

Stillbirth – transitions and rituals when birth brings death: Data from a danish national cohort seen through an anthropological lens

Many parents bereaved of a stillborn baby spend time with the child. In this time frame, different acts with the child in focus may occur. Some parents invite others to see the child too. Parents who suffer the loss of a newborn are vulnerable, and understanding acts and practices surrounding the dead newborn is important knowledge for caretakers. This article aims to enlighten the amount of time Danish parents spend with their stillborn in hospital settings that encourage this practice. Furthermore, it aims to transcend the mere quantitative numbers through a theoretical approach that frames the analysis and discussion of possible layers of meaning imbedded in time spent with a dead newborn. Data from a Danish cohort of bereaved parents were collected using web-based questionnaires. These numbers were successively interpreted through an anthropological lens within the perspective of transition and ritualisation. Knowledge from existing empirical literature was also fused. Danish parents spend hours or days with their stillborn child. They feel supported in this by healthcare professionals. Mainly close relatives join the parents while admitted to the hospital to see the stillborn child, followed by other family members and friends. Danish parents engage to a very high degree in contact with their dead baby. The analysis points out that 'Time' and 'Others' are needed to create a socially comprehensible status for parents and child when birth brings death. In liminal space during the transition, healthcare professionals act as ritual experts, supporting parents and their relatives to ascribe social status to the dead body of the child through ritualised acts. Instead of only thinking of this period as 'memory-making', we suggest regarding it as a time of ontological clarification as well.

DEVELOPMENT OF PERINATAL MEDICINE IN UKRAINE IN THE CONTEXT OF INTERNATIONAL APPROACHES

The aim: To realize analysis and assessment of completeness and efficacy in the field of perinatal aid regionalization in Ukraine. Materials and methods: A retrospective analysis has been carried out as well as assessment of inculcation steps concerning regionalization of perinatal health care in Ukraine according to the data of state and branch statistics and monitoring (in 2013-2017). The methods used here are systemic approach, bibliography method, and statistical data evaluation. Conclusions: It is shown the modern globally acknowledged three-level system of perinatal health care has been organized and functions in Ukraine, perinatal tertiary level centers are now act in the majority of regions. The perinatal health care realization during these last years is shown to be able to assure the providing of adequate perinatal aid taking into consideration the calculated data concerning the pregnant women concentration with high perinatal risks in third level institutions; these patients include pregnant women with heart defects (63.2-69.9%), circulatory system defects (48.5-50.5%), diabetes mellitus (46.7-53.3%); in institutions of the second-third levels, there are 74.2-83.0% of patients with severe gestoses. According to functional possibilities of perinatal aid institutions of different levels, they assure 62%-64.5% of births with body mass 500-999 g and 53.9%-55.3% of ones with body mass 1000-1499 g in perinatal clinics of the third level; it guarantees the survival of newborn babies with body mass 500-999 g and 1000-1499 g during their first 168 h reaching 60.1-65.1% and 89.4%-90.4%, respectively. Efficacy of perinatal aid regionalization is confirmed by a positive tendency of perinatal mortality index; it has become significantly lower: in 2010, the perinatal mortality reached 10.54 cases per 1,000 of newborn alive and dead babies, this index having dropped to 8.89 in 2019. The maternal mortality levels have also decreased from 23.5 up to 14.9 cases per 100,000 of babies born alive. Perinatal aid regionalization in Ukraine is being realized according to international strategies permitting to provide effective perinatal aid to patients at each level of its provision depending on patient's need.

On the casuistry of the Caesar section with narrow basins

The case described here concerns a 34-year-old woman who gave birth 6 times, now full-term, now premature, now living, now dead babies, now with medical help, now without her.

“Cutting Up Dead Babies”: The Literary Legacy of the Woman Physician as Abortionist

The gross perversion and destruction of motherhood by the abortionist filled me with indignation and awakened active antagonism. That the honorable term “female physician” should be exclusively app...

Analysis of infant and perinatal mortality in health care facilities of the Ministry of Health of Ukraine in 2019 according to the methodology of the World Health Organization «Matrix Babies»

The article provides information for 2019 on the number of children born alive and dead and the number of dead children under one year in health care facilities under the Ministry of Health of Ukraine. In 2019, 294148 live babies and 1733 dead babies were born, of whom 1585 died before birth and 148 during childbirth. Of those born alive in the early neonatal period, 904 infants died, of which 564 infants died in obstetric hospitals and 340 infants in hospitals other than obstetric hospitals. One of the indicators of the quality of medical services before, during and after childbirth, as well as one of the indicators of the quality of implementation of modern effective perinatal technologies, is the level of perinatal mortality and its components. Analysis of perinatal mortality and its components is performed according to the methodology of the World Health Organization «Matrix Babies», which allows you to analyze the provision of medical services to pregnant women, mothers and newborns using perinatal mortality and answer two questions: Are we doing what we need to do? Are we doing the right thing? Suggestions for improving the provision of medical services to pregnant women, mothers and newborns have been identified.

From self-compassion to compassionate action: reflecting on ending life of stillbirth care in nursing.

Nurses' distress in response to the professional experience of the neonatal loss and stillbirth care is poorly addressed in nursing practice; therefore, the purpose of this study is to explore nurses' experiences of labour of a stillborn baby. A qualitative approach with ten Registered Nurses from hospital birth units in northern Taiwan was used to investigate the stillbirth care experiences of nurses. Research data analysed by interpretative phenomenological analysis (IPA) were collected from eight digital recorded sessions of group dialogues, nurses' responses and feedbacks. Three main themes extracted from data include unfolding the suffering, engrossing in stillborn parents and demonstrating compassionate actions for the stillborn baby. Unfolding the suffering includes shame, guilt and disenfranchised grief. Engrossing in stillborn parents includes perceiving the mother's suppress sadness and empathising with the father's anger. Finally, demonstrating compassionate actions includes fulfilling the parents' needs to say goodbye to their stillborn baby and saying a personal goodbye to the dead baby. The finding of this study shows that the reflective group provided the space for nurses to unfold their suffering, share their emotion, and develop practical wisdom in caring for stillborn baby and the parents. The experience of nurse group conducting the reflecting dialogues could be a expository strategy to promote the nurse to provide the compassionate care actions.

The Relationship between Exposure Tobacco Smoke in Pregnant Women with Perinatal Death in Jember Regency

Perinatal death is an indicator of the success implementing a country's health services. Perinatal death rate in Indonesia in 2012 was 26/1000 live births. In 2017 there were 225 cases of infant mortality from 34,669 births in Jember Regency. Perinatal death is influenced by maternal, infant, health services and the living environment. The environmental conditions of the residence can be affected by cigarette smoke. The aim of this study was to determine the relationship of exposure tobacco smoke in pregnant women with perinatal death in Jember Regency and to find out the main source of exposure tobacco smoke in pregnant women in Jember Regency. Type of research is analytic observation with case control study design. The sampling technique is consecutive sampling. The study sample was mothers who had a dead baby in the perinatal period (perinatal death) who resided in the Jember regency on the birth of January-December 2017. The sample size was 30 for each group. Collected data was carried out by univariate analysis and bivariate analysis using the chi-square test and fisher exact test if the chi-square test requirements were not met. Results of univariate analysis in this study showed that 89.47% of the main sources of exposure tobacco smoke originated from home and 73.68% from husbands. Results of the chi-square test between exposure tobacco smoke with perinatal death p value 0.579 (p> 0.05). Confounding variables that had no significant difference between the case and control groups were parity (p = 0.116, p> 0.05), education (p = 0.083, p> 0.05), birth distance (p = 0.26, p> 0.05), and birth attendants (p = 0.492, p> 0.05). Based on the results of these studies it can be concluded that exposure tobacco smoke in pregnant women is not associated with perinatal death and the main source of exposure tobacco smoke in pregnant women comes from home and at most from husbands.
 
 Keywords: exposure tobacco smoke, pregnant women, perinatal death

Sudden Maternal Death from Suspected Amniotic Fluid Embolism and a Dead Baby Delivered with Natal Teeth

Amniotic fluid embolism (AFE) is a rare presentation in obstetric emergencies that carries great risk for the life of both mother and fetus. It is usually characterized by sudden cardiovascular collapse, respiratory distress and disseminated intravascular coagulation. Here we present a case of sudden death of a pregnant woman due to suspected AFE. We also present a rare finding of natal teeth in her deceased baby, which along with reported AFE in the mother, is an unlikely event in the medical literature.

The pregnancy outcome in patients with minor β-thalassemia

Background: Physiologic alterations during pregnancy worsen the anemia severity, and they are associated with an increased risk of fetal growth restriction, low birth weight, and preterm birth. Objective: The aim of the present study was to determine pregnancy outcomes in women with minor β-thalassemia. Materials and Methods: A total of fifty women who attended the consultation clinic of Azadi Teaching Hospital for antenatal care visit were screened consecutively and included in the present cross-sectional study in Duhok, Iraqi Kurdistan. The patients were followed up until delivery for pregnancy outcomes from May 20, 2018 to February 10, 2019. Results: About 14.0% of the patients had a history of baby death. The most prevalent clinical features were anemia (18.0%) and a history of preeclampsia (16.0%). Most of the patients had undergone a trial of normal vaginal delivery (80.0%), and 14.3% of their newborns were admitted to the neonatal intensive care unit (NICU). Only one of newborns died at 5 min following delivery due to a low Apgar score. The study showed that neonates who were admitted to the NICU had lower Apgar scores after 1 and 5 min compared to nonadmitted group (5.71 and 6.71 vs. 7.24 and 9.29, respectively). The mothers of the neonates who were admitted to the NICU had a higher prevalence of previous dead baby (42.9%; P = 0.031), previous history of preeclampsia (57.1%; P = 0.005), and more likely to undergone cesarean section (C/S) (71.4%; P = 0.001). Conclusions: The present investigation suggests that the β-thalassemia newborn admitted to the NICU had a higher prevalence of clinical issues compared to those not admitted to the NICU.

A full term abdominal pregnancy with an isthmic tubal implantation of the placenta

BackgroundAbdominal pregnancy is defined as the partial or total insertion of the embryo into the abdominal cavity. It is rare, and can evolve towards the full term if it is not recognized in the early pregnancy. It carries a high risk of maternal-fetal morbidity and mortality.Case presentationWe report a case of a 22 year-old gravida IV, para II with an asymptomatic and undiagnosed abdominal pregnancy presumed full term, in a context of health centers under-equipment. She had attended 5 routine antenatal care, but had not performed any ultrasound scan. She had been transferred from a medical center to the Hospital of Ouahigouya (Burkina Faso) for bowel sub-obstruction and intrauterine fetal death, with failure of labor induction. On admission, the hypothesis of uterine rupture or abdominal pregnancy with antepartum fetal demise was considered. A laparotomy was then performed, where an abdominal pregnancy was discovered, and a dead term baby weighing 3300 g delivered. The placenta which was implanted into the ruptured isthmus of the left fallopian tube was removed by salpingectomy. Postoperative follow-up was uneventful.ConclusionThis case report exposes the necessity for the practitioner to think about the possibility of abdominal pregnancy in his clinical and sonographic practice, irrespective of the gestational age, mainly in contexts where there is under-equipment of the health centers.

Case Report: Spontaneous Fundal Uterine Rupture in a Grand Multipara before Onset of Labor

ABSTRACT Uterine rupture is an obstetric emergency and which is associated with high maternal and fetal morbidity and mortality. It commonly occurs in uterus with one or more previous scar but is rare in unscarred uterus and especially without labor. The researcher presents a case of fundal uterine rapture in a 35 years old grand multipara who present with abdominal pain of 24 hours’ duration. But she has no history of pushing down pain (labor) and no history of trauma. Intraoperative finding showed fundal uterine rupture with a freshly dead baby free in the peritoneal cavity and total abdominal hysterectomy was done. Keyword: Uterine fundus, rupture (Ethiopian Journal of Reproductive Health 2018;10:65-69)

Quetzalcoatl

Quetzalcoatl Rafael Gonzalez (bio) n.Quetzalcoatl plumed snake: elegancein the sun’s gold. Quetzalcoatl slithersand spine. Human sacrifice, a heartheld with one hand and lifted upward.In cupped hands, I offer the remainingsemen. You swat my hand and tell me,“I’m not about to eat your dead babies.”Oh, blue eyes, if you only understoodwhat the eagle perched on the cactusmeant—or why it’s eating a snake.Quetzalcoatl rising star of the East. Deityof creation. Christ framed in serpentand gems. In the Zócalo, I see men invokingthe sun with sage. In the same fashion,I pull you towards me and blowcigarette smoke—you choke. This is mycollection of fake gems, this is me not caringfor where the accent goes. Quetzalcoatlmyth and deliver. Quetzalcoatl birdman and snake. [End Page 109] Rafael Gonzalez Rafael E. Gonzalez lives in Tucson, AZ where teaches at the University of Arizona and is a poetry editor for DIAGRAM. Copyright © 2018 Pleiades and Pleiades Press

Risk and Reputation: Obstetricians, Cesareans, and Consent.

When physicians performed cesarean sections in the nineteenth century, they customarily sought agreement from all present before proceeding. In contrast, after the introduction of electronic fetal monitoring in the late 1960s, obstetricians obtained permission for a cesarean by offering a choice that ensured consent-give birth by cesarean or give birth vaginally to a damaged or dead baby. This article argues that the manner in which physicians obtained consent for cesareans in the nineteenth century was one factor that kept the cesarean rate low, while the manner in which physicians obtained consent in the late twentieth and early twenty-first centuries was one factor driving up the cesarean rate. The dissimilar approaches to consent did serve a common purpose, however. Each preserved physicians' reputations. With the surgery likely to end in a woman's death in the nineteenth century, consensus ensured that a bad outcome would be a shared burden. And because the fetal monitor, in exaggerating the risks of vaginal birth, changed the nature of the malpractice climate for obstetricians, the late-twentieth-century approach to consent similarly protected physicians. As one early twenty-first-century obstetrician quipped, "You don't get sued for doing a C-section. You get sued for not doing a C-section."

Dead Babies and Adulterers: Literary Prophylaxis in On the Face of the Waters

Dead Babies and Adulterers: Literary Prophylaxis in <i>On the Face of the Waters</i>