A prospective observational study to evaluate mode of delivery in antepartum still birth in a tertiary care set up of South Gujarat

Abstract

Objective: Stillbirth, particularly antepartum foetal demise, represents a profound obstetric tragedy with significant impact on global and national health, as well as medicolegal implications in modern times. Despite advancements in maternal care, stillbirth rates remain a concern, especially in low and middle-income countries like India. The optimal mode of delivery in these sensitive circumstances balances maternal physical safety with psychological well-being and future reproductive health.This paper aims to provide a comprehensive review of the modes of delivery for antepartum stillbirth, evaluating maternal outcomes, exploring ethical considerations, and identifying critical research gaps relevant to the Indian context.Results: Vaginal delivery, primarily through induction of labor, is generally recommended as the preferred mode for most antepartum stillbirths due to lower maternal morbidity compared to caesarean section. However, individualized care considering gestational age, maternal obstetric history (e.g., prior uterine scar), and patient preference is paramount. Caesarean section is reserved for specific maternal indications. The psychological impact of stillbirth is profound, with the mode of delivery potentially influencing maternal mental health, necessitating compassionate, patient-centred counselling and support.Conclusion: To conclude, effective management of antepartum stillbirth requires adherence to evidence-based guidelines while prioritizing maternal autonomy and emotional support. Addressing existing research gaps, particularly in data collection is crucial for improving outcomes and providing holistic care in India.