Stillbirth Top 10

1. How can the structure and function of the placenta be assessed during pregnancy to detect potential problems and reduce the risk of stillbirth?
2. Does ultrasound assessment of fetal growth in the third trimester reduce stillbirth?
3. Do modifiable ‘lifestyle’ factors (e.g. diet, vitamin deficiency, sleep position, sleep apnoea, lifting and bending) cause or contribute to stillbirth risk?
4. Which investigations identify a fetus which is at risk of stillbirth after a mother believes she has experienced reduced fetal movements?
5. Can the wider use of existing tests and monitoring procedures, especially in later pregnancy, and the development and implementation of novel tests (biomarkers) in the mother or in early pregnancy, help prevent stillbirth?
6. What causes stillbirth in normally grown babies?
7. What is the most appropriate bereavement and post natal care for both parents following a stillbirth?
8. Which antenatal care interventions are associated with a reduction in the number of stillbirths?
9. Would more accessible evidence-based information on signs and symptoms of stillbirth risk, designed to empower women to raise concerns with health care professionals, reduce the incidence of stillbirth?
10. How can staff support women and their partners in subsequent pregnancies, using a holistic approach, to reduce anxiety, stress and any associated increased visits to healthcare settings?
11. Why is the incidence of stillbirth in the UK higher than in other similar high-income countries and what lessons can we learn from them?

The remaining questions discussed at the workshop were (in no order of priority):

• What causes stillbirth, or increases the likelihood of it occurring? 
• Would increasing the frequency of umbilical artery Doppler scanning during pregnancy reduce stillbirth?
• Why is stillbirth not discussed with parents during pregnancy?
• Can we examine the placenta during pregnancy to assess the risk of stillbirth?
• Are there any markers, either in the mother or in early pregnancy, that indicate the risk of stillbirth occurring (ie, biomarkers, diagnostic tests)?
• What is the best way of educating women about fetal activity and reduced fetal movements in pregnancy?
• Should parents be cared for in specialist bereavement rooms on the maternity suite?
• How can umbilical cord function and any associated problems be detected during pregnancy?
• Does formal fetal movement counting (e.g. 'kick counting') reduce the number of stillbirths?
• What support do fathers need and what is currently available to support them?
• Should there be increased screening of blood to detect: a) obstetric cholestasis, b) Antiphospholipid syndrome, c) Systemic Lupus Erythaematosus, d) infection (viral and bacterial), e) gestational diabetes, f) preeclampsia? 
• How can we ensure care and support in a subsequent pregnancy is based on assessment of the woman's individual circumstances as well as the research evidence?
• What is the best way to educate parents about signs and symptoms relating to stillbirth?
• Would educating parents about relevant signs and symptoms reduce the number of stillbirths? 

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For full details of all of the questions identified by this PSP, please see the document below