Totgeburt und plötzlicher Kindstod

During the last 30 years the rate of stillbirths in industrial countries has remained nearly identical, while neonatal mortality und the incidence of the sudden infant death syndrome (SIDS) has declined significantly. This observation is in contrast to the decline of stillbirths due to placental insufficiency, maternal diabetes mellitus, preeclampsia, rhesus incompatibility and fetal aneuploidy. However, the incidence of unexplained stillbirths has increased. The decrease of the incidence of the sudden infant death syndrome proves that prevention of diseases of unknown origin is possible. Smoking, obesity and an excessive increase in body weight before pregnancy are modifiable risk factors for intrauterine stillbirth. The detection and treatment of diabetes mellitus, gestational diabetes and arterial hypertension are effective measures in pregnancy to reduce the risk for stillbirth. The induction of labor at term is also effective in the reduction of stillbirths, however, the burden of elective induction with all of the possible negative effects has to be balanced against the benefit of avoiding intrauterine deaths as approximately 300 labor inductions with the corresponding disadvantages, would be necessary to avoid 1 stillbirth.