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Print Posted on 07/05/2018 in Pregnancy

Stillbirth. Fetal Loss in the Third Trimester: Why Does It Happen?

Stillbirth. Fetal Loss in the Third Trimester: Why Does It Happen?

The honeymoon or ‘BABYMOON’ trimester was over, and the final trimester was coming. That last trimester was the time when you felt like a bundle of nerves. And Your baby bump was accurately shaped one moment and reshaped the other moment. Your fetus loved to curl up inside so much and sometimes that curling up was painful. Sometimes, you were exhausted because of all these things occurring to you. And sometimes, you were annoyed by that fetal kicking, which was once so delicate and so cute but in the third trimester became more than slightly stronger.

BUT in one moment that ideal reality was completely disrupted. Everything has suddenly stopped. That annoying fetal kicking, that painful fetal curling up, that confusing representation of the fetal feet or fetal palm. The fetal party was over.

You hugged your belly with your ten fingertips. You tried to discuss with your fetus the new golden tulle outfit for the BIRTHDAY. You talk with your fetus loudly enough. You listened to music. You strolled down the streets and breathed that scented air–flows deeply. But THERE WAS NO RESPONSE. Your fetus was so silent.

Were you confused? Were you embarrassed? Were you frustrated? Were you shocked? Were you utterly scared? Not only. You were extremely anxious. Frustrating thoughts bubbled into your consciousness, tears streamed down your face, making your gorgeous eyes blurred. You screamed in a despair as you were literally locked inside your body. The only thing you could control were your thoughts. You could control only your thoughts, and nothing more! And it was the scariest thought you have ever had in your mind.

After that, you felt that you could not breathe as usual. Something was wrong with your breathing. You were literally GRASPING those air flows and it hurt. Something was wrong with you. You could not concentrate your thoughts. You were scared and lost. You felt GUILTY in everything that was happening to you.

You felt several strong cramps, and after that, there was excruciating pain. Ten minutes later there was heavy bleeding, strong cramping, and too much pain. You reached the sofa and curled up into a ball. It was too much pain.

The emergency room didn’t keep you waiting for long. You were completely lost when you glanced beneath your legs. Nobody had ever told you that there would be so much blood in case if the miscarriage occurs. You thought the blood trail that was following your tail end had “urgent” written all over me.

The last thing you could remember was the words of the experienced physician: “It is a stillbirth. Your fetus is dead.” And you fell unconscious.

This is how the STILLBIRTH happens. This is one of the scenarios it has. But not only this one.

(1) What is a “STILLBIRTH”? 

If the pregnancy loss happens at 24 weeks or later, it is correctly called a “STILLBIRTH”.

STILLBIRTH has three categories, according to the timeline when it occurred: (1) EARLY stillbirth, (2) LATE stillbirth, (3) TERM stillbirth.

If a fetal death occurred between 20 and 27 completed weeks of pregnancy, it is called an EARLY stillbirth.

If a fetal death occurred between 28 and 36 completed pregnancy weeks, it is called a LATE stillbirth.

If a fetal death occurred between 37 and 40–41 completed pregnancy weeks, it is called a TERM stillbirth.

(2) “Is it MY GUILT?”

This QUESTION will be always in your mind. Your cognition will reframe it in many other versions, but still, it will be the same QUESTION. “Is it MY GUILT?” “Am I the only one who is GUILTY?” “I must have done something to prevent that. The only person who is GUILTY – is me.” “I had the gift holding you every second that your tiny heart was beating, until the moment it stopped. I fell in love with you when you first kicked me, and now I hold you in my heart. You were just too perfect, too beautiful for this earth, and now you’re an angel instead. And it is my GUILT. My GUILT. Only my GUILT.”

“Is it MY GUILT?” –– NO. This is NOT YOUR GUILT. I may write these words million times, but this question will be reshaped in your mind. Therefore, let’s start with the ESSENSE of GUILT.

Guilt makes all your failure–related remembrances so vivid as everything you thought about has just happened to you. Guilt makes you overanalyze things or overthinking them. Wondering WHY?

Guilt whispers: “This was wonderful, but it was TOO WONDERFUL for YOU. There was no way this was going to last FOR YOU”.

The truth is that guilt is the greatest destroyer of emotional energy. It leaves you feeling excessively exhausted both emotionally and physically in the present by something that has already occurred. Guilt HURTS too much. You don’t feel your own body.

The GUILT–ENTAILED thoughts will ‘SHOUT” and “SCREAM” in your mind. After that, the dark, hard, the most challenging emotions will appear and grasp your breath. BUT it is normal to have these thoughts in your mind. It is normal to feel self–GUILT if you have lost your much–loved fetus. The LOSS is the HARDEST experience. The LOSS is the MOST FRUSTRATING experience. The LOSS is the MOST TRAGIC experience.

BUT GUILT is here to wake you up. Embrace it. Reshape it. YES, it is not beautiful, it is not gorgeous, and it glows differently, with dark light. It even can be dreadful. It can be tearful. It can hurt. YES, the GUILT’S VOICE is an AWFUL SCREAM, undesirable to hear. But listen to that LOUD SCREAM and try to understand what it wants you to hear even if it sounds intimidating. It tries hard and passionately to tell you something and to make your fortune different.

(3) Are there any RED FLAGS that literally ‘SCREAM’ that the STILLBIRTH may happen? 

NEVER IGNORE or NEGLECT THESE RED FLAGS! Wondering why? The consequences may be fatal.

(1) THE FETAL KICKING is too DELICATE. The response from your fetus is not powerful but WEAK. Usually, the fetuses love kicking very much. Do you remember those exciting moments when you felt those first little flutters of your fetus’s kicking? You should! Week after week, fetal kicking became STRONGER and STRONGER.

Starting from 28 weeks, your fetus should move not less than 10 movements within two hours. Take into consideration that the fetuses are active when you are sleeping or lying on the bed. If your fetus kicking is too WEAK, maybe your bundle has curled up into a ball and is sleeping. BUT if you count less than 10 movements within two hours, call your doctor right away.

(2) THE FETAL MOVEMENT is too SLOW. Fetuses do love having the choreography classes. Having at least one fetus curled and cuddled up inside means that your fetus practices all the footloose, gravity–free ballet movements. Yup, that is the truth. All your fetus’s time is devoted to choreography. Your fetus loves to balance his/ her body ‘En Pointe’, show you the ‘Allongé’, perform a footloose ‘Attitude’, curl himself/herself up, twist, turn, stretch, kick, and perform the other choreography. So, your belly is the place of ‘fetal party’. And every next week this ‘fetal party’ is louder as your bundle performs not only ‘En Pointe’, ‘Allongé’, or a footloose ‘Attitude’!

You FEEL that your small bundle’s initial fluttering ballet movements turn into full–fledged kicks and nudges. Ballet technique becomes more accurate and advanced. All those delicate sautés, jetés, assembles, Allongés, Arabesques, Attitudes, Adagios, Fondus, turn into full–fledged ones.

You know that your fetus LOVES, LOVES, LOVES moving! You know the time when the fetal party usually starts, right? BUT if you notice your fetus is moving less than normal, call your doctor right away.

(3) THE FETUS STOPS MOVING/KICKING. If your fetus is not moving at all, call your doctor right away.

(4) Your waters broke. If your WATERS BROKE [before reaching at least 36 weeks], immediately call the Ambulance or ask to drive you to the EMERGENCY DEPARTMENT. 

(5) The most serious RED FLAGS are spontaneous CRAMPING and BLEEDING. Or spontaneous BLEEDING and CRAMPING. Therefore, you should remember these two FLAGS are really very serious. You shouldn’t wait until you would feel better. Because the situation might be worse than you think. Call the Ambulance immediately. NO WAITING TIME IS LEFT!

(4) Are there any RED FLAGS that literally ‘SCREAM’ that the STILLBIRTH has already happened or had happened? 

(1) The most serious RED FLAGS are spontaneous CRAMPING and BLEEDING. Or spontaneous BLEEDING and CRAMPING. Therefore, you should remember these two FLAGS are really very serious. You shouldn’t wait until you would feel better. Because the situation might be worse than you think.

The BLEEDING is the RED FLAG NUMBER ONE. The CRAMPING is the RED FLAG NUMBER TWO. 

(2) EXCRUCIATING PAIN, BLEEDING and CRAMPING [or CRAMPING and BLEEDING] that don’t stop ‘SHOUT’ that you may have the miscarriage. And it is of vital importance to call the Ambulance if the bleeding is too heavy and the cramping is too intensive. 

(3) THE FETUS STOPPED MOVING/KICKING. There is no fetal kicking for two hours whatever you do. Whenever you are sitting, or staying, or lying or has just drunk a glass of mineral water, a cup of warm tea, or a glass of fruit juice.

If you have at least one symptom like these: BLEEDING, PAINFUL CRAMPS, STABBING PAIN in your LOWER ABDOMEN, FLU SYMPTOMS, FEVER, SEVERE SHOULDER PAIN, YOU MUST call your doctor and Ambulance. If your fetus MOVES too SLOW, STOPS MOVING and KICKING, if your WATERS BROKE, CALL the AMBULANCE. 

The TIME is EVERYTHING. And the life–threatening situation may occur if you lost the time. It is the mystery of life – some things can give you such beauty for such a short period of time, feeling like they would last forever but also were terminated before they really had a chance to shine.

(5) What may cause the STILLBIRTH? 

The most common causes of the STILLBIRTH are the following. 

(1) Problems with the placenta and/or umbilical cord. The placenta is a temporary multifunctional organ that lines the uterus of pregnant women. It is designed for the exchange of oxygen, nutrients, antibodies, hormones, and waste products between the mother and fetus. The fetus gets the blood, oxygen, and nutrients through the placenta and umbilical cord, so problems in either will affect the fetus.

(2) Placental and fetal infections. The infections may cause not only severe maternal illness. The infections may infect the placenta and prevent oxygen and nutrients transfer from mother to the fetus. Infection may damage a vital organ such as the brain or heart of the fetus and may cause preterm labor, with the fetus dying in labor.

(3) Viral infections.

(4) Mother’s high blood pressure that is called “PREECLAMPSIA”. 

(5) Diabetes.

(6) Lupus.

(7) Heart or thyroid disease.

(8) Fetomaternal hemorrhage.

(9) Chromosomal abnormalities. 

(10) Uterine complications.

(6) What are the treatment options? 

There are two treatment options they will propose you. The first option is the Labor induction. If you choose this option that seems that you would deliver naturally but with the labor–inducing medications. Medical management involves taking one or more medications to cause the cervical dilation and allow the fetus and placenta to be delivered naturally. The other option is a surgery. It is called a Cesarean Section or a C–section.

CONCLUSIVE REMARKS:

Every pregnancy is the absolutely unique phenomenon. It should be the utmost accurately monitored by the experienced doctor. Never IGNORE or NEGLECT the first signs that something is wrong. Even if it is only based on your FEELINGS. As it may be too late to do something.

If you have at least one symptom like these: BLEEDING, PAINFUL CRAMPS, STABBING PAIN in your LOWER ABDOMEN, FLU SYMPTOMS, FEVER, SEVERE SHOULDER PAIN, YOU MUST call your doctor and Ambulance. If your fetus MOVES too SLOW, STOPS MOVING and KICKING, if your WATERS BROKE, CALL the AMBULANCE. 

The TIME is EVERYTHING. And the life–threatening situation may occur if you lost the time. It is the mystery of life – some things can give you such beauty for such a short period of time, feeling like they would last forever but also were terminated before they really had a chance to shine.

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