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What are the causes of stillbirth?

Q: My sister had a still born baby in her 8th month. She was at Detroit - Michigan, U.S.A. during her pregnancy. In the initial stages of her pregnancy, it was found that she was immune to Rubella IgG with 2.16 count positive. 1. Is there a possibility for a baby to be still born when she is immune to Rubella IgG positive with a count of 2.16? 2. Should the IgM also be positive? 3. She went for a general scan in her 8th month. She had a regular checkup a couple of days back. The doctor found that her weight, BP was normal. The doctor could hear the baby's heart beat also. 4. The general check up was on a Thursday. On Monday, the scan showed that the baby was still. What would have happened in a couple of days? The doctors told my sister that the baby would have passed away in a span of 24 to 48 hrs. My sister did not have any ill symptoms. 5. Will rubella infection in the fetus of a mother cause a still birth during the 8th month? 6. If you feel that a count of 2.16 of IgG rubella positive will not be a reason for a still birth, what could have been the reason for a pregnancy to fail in the 8th month? Say in general for an x if she has a still birth baby in 8th month what would be the reason...let us assume that the x is already immune to Rubella. 7. My brother-in-laws blood group is B+ and my sisters is O+. Do these blood groups cause any problem in having a still born? 8. Should my sister take a vaccine for Rubella? Please do help us with your opinion and suggestions.

A:The positive rubella titre is unlikely to be the cause of stillbirth. There are several causes of stillbirth in the 8th month and your sister needs to be investigated for those. Sometimes no cause can be clearly identified and several precautions need to be taken in the next pregnancy. ABO incompatibility can sometimes cause a stillbirth but this is a rare phenomenon - the blood groups are suggestive but not conclusive. Since your sister is immune to rubella, she does not need to be vaccinated. However her titres of rubella will need to be followed up in the next pregnancy.

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