A study of intrauterine fetal death in a tertiary care hospital

Background: Intrauterine fetal death is a major obstetrical complication and a devastating experience for parents as well as obstetricians. If the causes of IUFD can be found, an effective strategy for prevention of IUFD can be formed and maternal complications can thus be prevented. This study aims at identifying the various causes, etiological factors and complications of IUFD.Methods: Prospective observational study was carried out in a tertiary care hospital from 1st January 2016 to 31st July 2017.Results: Total number of deliveries during the study period was 3944 and still birth was 170. Still birth percentage was 4.31.Majority of patient belonged to maternal age group of 21-30 year of age that is 138 out of 170 around 68.5%. Only 8.82% of patients presenting with IUFD were having more than three antenatal visits. Among 61 cases (35.8%) cause was not identified while 109 cases cause was identified. Hypertensive disorder contributed to major cause of IUFD i.e. 34 out of 170 (20%) Maternal complications like hypovolemic shock occurred in 13 out of 170 (7.6%), Acute Renal failure 7 out of 170 (4.11), Sheehan syndrome. Maternal mortality was 3 out of 170 cases.Conclusions: Despite availability of modern interventions like ultrasonography, Non stress test, majority of the causes of IUFD remains unknown. Early diagnosis and delivery is important in cases of IUFD to prevent various complications like septicaemia, acute renal failure, DIC, hypovolemic shock etc.

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A prospective study of intrauterine death cases at a tertiary care hospital

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20210319 ◽

2021 ◽

Vol 10 (2) ◽

pp. 638

Author(s):

Nabila N. Tai ◽

Rinku Mulchandani ◽

Dipti A. Modi ◽

Bijal Rami

Keyword(s):

Prospective Study ◽

Fetal Death ◽

Tertiary Care ◽

Mode Of Delivery ◽

Intrauterine Fetal Death ◽

Intrauterine Death ◽

Care Hospital ◽

Risk Pregnancy ◽

A Prospective Study ◽

Death Cases

Background: Intrauterine fetal death is defined as foetus with no signs of life in utero after 20 weeks of gestations. Stillbirth is a useful index to measure the values of antenatal and intra-natal care. Intrauterine fetal death is due to various causes whether it be maternal causes, fetal causes or placental causes.Methods: It was a prospective study, conducted at SSG hospital, Vadodara over a period of 1 year from January 2019 to December 2019. All pregnant women coming to labour room with intrauterine fetal death with gestation age more than 28 weeks were included in study. It included complaints on admission, obstetric profile, mode of delivery, fetal outcomes, placental examination, condition of cord and investigation reports.Results: During the study period of one year, a total of 462 intrauterine fetal deaths were reported amongst 7295 deliveries conducted during the study period. Incidence rate calculated was 63/1000 births. Many of the intrauterine fetal death cases were associated with pregnancy induced hypertension and antepartum hemorrhage. Out of all intrauterine death cases, 410 cases delivered vaginally. Congenital anomalies were also found to be associated with intrauterine death cases.Conclusions: High risk pregnancy cases should be identified during routine antenatal check-ups so that intrauterine fetal death can be prevented. The mode of antepartum and intrapartum surveillance for fetal wellbeing should be advanced to prevent fetal demise.

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Study on Etiology and Maternal Complications of Intrauterine Fetal Death

Chattagram Maa-O-Shishu Hospital Medical College Journal ◽

10.3329/cmoshmcj.v18i1.42133 ◽

2019 ◽

Vol 18 (1) ◽

pp. 23-26

Author(s):

Adiba Malik ◽

Tahera Begum ◽

Serajun Noor

Keyword(s):

Risk Factors ◽

Antenatal Care ◽

Fetal Death ◽

Tertiary Care ◽

Cross Sectional Study ◽

Intrauterine Fetal Death ◽

Care Hospital ◽

Maternal Complications ◽

Cross Sectional ◽

Antenatal Visits

Background : Management of pregnancy with good fetal and maternal outcome is a challenge to the obstetrician which can be achieved by screening the risk factors of Intra Uterine Fetal Death (IUFD) and thereby prevent, control and treat them by quality preconceptional and antenatal care. Materials and methods: This cross-sectional study, done in a tertiary care hospital during a period of two years where 100 pregnant women with history of intrauterine fetal death were included after informed written consent. Intrauterine fetal death was confirmed by Ultrasonogram. Different risk factors and maternal complications were observed. Then data was analyzed with the help of SPSS-20. Results: Among 100 women, maximum patients were aggregated between age group 26-35 years (45%) and next to which was 16-25 years (35%) primipara was 32% and multipara was 31%. Regarding Antenatal care (ANC) 32% patients attended two antenatal visits and 28 % patients had no antenatal visits and 18% patients completed > 5 visits. Regarding causes of IUFD, 34% due to hypertension in pregnancy, 14% mother was severely anemic, 13% mother had Diabetes Mellitus (DM) abruptio placenta was found in 15% mother, maternal gastroenteritis 05%, maternal fever 09%, cord accident 3% and in 19% cases no causes were identified. Regarding maternal complications, blood transfusion needed in 28% patients, PPH occurred in 12% patients, Sepsis 08%, caesarean section needed in 07 % cases, ARF 4%, DIC in 03% cases and maternal mortality 01%. Mean ± SD of total hospital stay was 4 ± 1.5 days. Conclusion: There are different risk factors of IUFD which if identified earlier,then by treating the correctable etiologies, recurrence of IUFD and its related maternal complications can be prevented or reduced. Chatt Maa Shi Hosp Med Coll J; Vol.18 (1); Jan 2019; Page 23-26

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Placental pathology in intrauterine fetal death

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl4.4480 ◽

2020 ◽

Vol 11 (SPL4) ◽

pp. 2376-2380

Author(s):

Nanda J. Patil ◽

Jyoti S. Tele ◽

Rohit S. Kadam ◽

Pawar S. J ◽

Sujata M. Kumbar

Keyword(s):

Fetal Death ◽

Tertiary Care ◽

Cross Sectional Study ◽

Mirror Image ◽

Intrauterine Fetal Death ◽

Care Hospital ◽

Placental Pathology ◽

Cross Sectional ◽

Present Cross Sectional Study ◽

To Come

Placenta is the most accessible and readily evaluable specimen which is mirror image of pregnancy. The objective here is to study the histomorphological changes in placenta in cases of intrauterine fetal deaths and to study correlation of placental findings with causes of fetal death which is significant to understand. The present cross sectional study was carried out in Department of Pathology of a tertiary care hospital from June 2015 to May 2017. Study of Placental Pathology in Intrauterine Fetal Death cases comprised of 99 placentas. The present study was undertaken to study the placental pathology in cases of intrauterine fetal death. IUFD was found to be more common in primigravida 50/99 (50.50%) mothers. Placental study gives useful morphological information regarding the abnormality of pregnancy. Gross and microscopic examination of the placenta plays an important role in identifying the underlying causes of fetal death and helps prevent further recurrence by making appropriate interventions during the next pregnancy. Study of placental pathology gives clues to events occurring throughout gestation and can potentially help to answer, questions concerning pregnancy management and risk assessment of future pregnancies. It will help the researchers who are doing the research in the field of placental pathology in the days to come.

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Analysis of factors responsible for intrauterine fetal death in rural pregnant women at tertiary care centre of Northern India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20174064 ◽

2017 ◽

Vol 6 (9) ◽

pp. 4071 ◽

Cited By ~ 2

Author(s):

Shaveta Garg ◽

Naina Kumar

Keyword(s):

Fetal Death ◽

Tertiary Care ◽

Intrauterine Fetal Death ◽

Care Hospital ◽

Tertiary Care Centre ◽

Northern India ◽

Number Of Patients ◽

Tragic Event ◽

Abruptio Placenta ◽

One Year

Background: Intrauterine fetal death (IUFD) is a tragic event for both the parents and obstetrician. Objectives of current study were to study the underlying etiology of Intra Uterine Fetal Death (IUFD) that can be helpful in formulating the preventive measures.Methods: This study was conducted over a period of one year from April 2016 till March 2017 at a tertiary rural care hospital. All patients with diagnosed IUFD at >24 weeks of gestation were included in the study.Results: Total eighty patients were admitted with diagnosis of intrauterine fetal death. Among these majority 58 (72.5%) were multigravida and only 22 (27.5%) were primigravida. Maximum number of patients, 61 (72.5%) were between age group of 20-30 years. Maximum number of IUFD were reported between 36-40 weeks of gestation (36.25%). Most of fetal deaths were due to preventable conditions like hypertensive disorders of pregnancy (28.75%), severe anemia (15%), abruptio placenta (11.25%), and rupture uterus (10%). Out of these patients 68 (85%) delivered vaginally and 7 patients were delivered by LSCS.Conclusions: The present study emphasizes the role of health education, regular antenatal checkups, early detection of complications and hospital delivery to reduce the overall preventable IUFD.

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Maternal and fetal characteristics and causes of stillbirth in a tertiary care hospital of Nepal: secondary analysis of registry-based surveillance data

BMJ Open ◽

10.1136/bmjopen-2020-045012 ◽

2021 ◽

Vol 11 (8) ◽

pp. e045012

Author(s):

Basant Sharma ◽

Suraj Bhattarai ◽

Sabita Shrestha ◽

Rakshya Joshi ◽

Renuka Tamrakar ◽

...

Keyword(s):

Antenatal Care ◽

Outcome Measures ◽

Fetal Death ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Secondary Analysis ◽

Surveillance Data ◽

Secondary Outcome ◽

Care Hospital ◽

Maternal Hypertension

ObjectivesStillbirth is one of the vital indicators of quality care. This study aimed to determine maternal-fetal characteristics and causes of stillbirth in Nepal.DesignSecondary analysis of single-centred registry-based surveillance data.SettingThe study was conducted at the Department of Obstetrics and Gynecology, Chitwan Medical College Teaching Hospital, a tertiary care hospital located in Bharatpur, Nepal.ParticipantsAll deliveries of intrauterine fetal death, at or beyond 22 weeks’ period of gestation and/or birth weight of 500 g or more, conducted between 16 July 2017 and 15 July 2019 were included in the study.Main outcome measuresThe primary outcome measure of this study was stillbirth, and the secondary outcome measures were maternal and fetal characteristics and cause of stillbirth.ResultsOut of 5282 institutional deliveries conducted over 2 years, 79 (1.5%) were stillbirths, which gives the stillbirth rate of 15 per 1000 births. Of them, the majority (75; 94.9%) were vaginal delivery and only four (5.1%) were caesarean section (p<0.0001). The proportion of the macerated type of stillbirth was more than that of the fresh type (58.2% vs 41.8%; p=0.13). Only half of the mothers who experienced stillbirth had received antenatal care. While the cause of fetal death was unknown in one-third of cases (31.6%; 25/79), among likely causes, the most common was maternal hypertension (29.1%), followed by intrauterine infection (8.9%) and fetal malpresentation (7.6%). Four out of 79 stillbirths (5%) had a birth defect.ConclusionHigh rate of stillbirths in Nepal could be due to the lack of quality antenatal care. The country’s health systems should be strengthened so that pregnancy-related risks such as maternal hypertension and infections are identified early on. Upgrading mothers’ hygiene and health awareness is equally crucial in reducing fetal deaths in low-resource settings.

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Intrauterine fetal death: Five years’ experience in a secondary care hospital.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.08.4721 ◽

2021 ◽

Vol 28 (08) ◽

pp. 1076-1082

Author(s):

Erum Saleem Khan ◽

◽

Mahwash Jamil ◽

Reeta Chanderparkash ◽

Sheikh Irfan ◽

...

Keyword(s):

Fetal Death ◽

Tertiary Care ◽

Gynecologic Cancer ◽

Care Facility ◽

Intrauterine Fetal Death ◽

Normal Vaginal Delivery ◽

Care Hospital ◽

Fetal Demise ◽

Intrauterine Fetal Demise ◽

Tertiary Care Facility

Objectives: The objectives of this study were to estimate the prevalence, preoperative, and operative risk factors associated with the higher risk of SSI in gynecologic cancer patients undergoing surgery in a tertiary care facility in a developing country. Study Design: Retrospective Study. Setting: Obstetrics and Gynecology Department, Agha Khan Hospital for Women Garden Karachi, Pakistan. Period: Jan 2012 to Dec 2016. Material & Methods: Retrospective review of medical records of patients over a period of five years from Jan 2012 to Dec 2016 was done. Results: The study consisted of 56 cases of intrauterine fetal demise out of 4813 number of deliveries which occurred during the study duration. Overall estimated rate of intrauterine fetal demise was 11.6 %( 56/4813). Approximately 33.9% of cases did not have a clear cause of fetal death identified and hence were un-explained. In 56 cases, 28.6% had some form of congenital abnormality identified on ultrasound, 7.1% (n=4) had anemia, 23.2% (n=13) IUGR, 5.4% (n=3) placental abruption and 1.8% (n=1) of gestational diabetes and around 83.9% (n=47) had normal vaginal delivery and 8 were delivered by LSCS and only 1 patient had instrumental delivery. Fetal characteristics identified 50% (n=28) were males and 50% (n=28) were females. 4 fetuses were born with tight cord around their neck 58.1% were macerated stillbirths (n=25) while 32.6% were fresh stillbirth. Conclusion: Antepartum intrauterine fetal death or stillbirths in the third trimester, affect the entire family. We conclude from our study that quality antenatal care with health education and timely interventions can reduce the number of intrauterine fetal deaths thus reducing the psychological sequelae.

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