From the Research
The immediate management for a 30-year-old primipara who delivered a stillbirth involves both medical and psychological care, prioritizing physical stability, pain management, and emotional support. First, ensure the mother's physical stability by monitoring vital signs, assessing bleeding, and managing any obstetric complications. Administer oxytocin (10 units IM or IV) to prevent postpartum hemorrhage, as recommended by general medical guidelines 1. Provide appropriate pain management with medications such as ibuprofen 600mg every 6 hours or stronger analgesics if needed. Allow the mother and family time with the baby if desired, offering to take photographs, footprints, or other mementos. Arrange for psychological support through a mental health professional and connect the family with bereavement services, which is crucial for their mental health and well-being 2.
Some key considerations in the management of stillbirth include:
- Laboratory evaluation to identify potential causes of stillbirth, such as karyotyping, maternal antibody screening, and placental pathology 1
- Lactation suppression options, such as tight breast binding or medication (cabergoline 1mg as a single dose) 3
- Scheduling a follow-up appointment within 1-2 weeks to address physical recovery, discuss autopsy results if performed, and evaluate mental health 1
It's essential to note that while the provided studies offer valuable insights, the most recent and highest-quality study should guide the management approach. However, based on the available evidence, a comprehensive approach addressing both physical and psychological needs is recommended. The management of stillbirth is a complex and sensitive issue, requiring a multidisciplinary approach that prioritizes the mother's physical and emotional well-being.