A study of intrauterine fetal death in a tertiary care hospital
Keywords:Intra uterine fetal death, Risk factors, Stillbirth, Maternal factors
Background: Intra uterine fetal death (IUFD) is the most traumatic event for the parents and the treating obstetrician. If the causes of IUFD can be found, an effective strategy for prevention can be formulated. This study was done to study the etiological factors and other determinants of IUFD.
Methods: A retrospective observational study was carried out in M. S. Ramaiah medical college and teaching hospital, Bangalore, India between December 2011 to December 2014. 120 cases of IUFD were included in this study.
Results: Out of 4103 deliveries that occurred during the study period, there were 120 IUFD (2.9%). 52 cases (43.3%) were referral cases. Majority were multigravida(n=73,60.8%) aged less than 30 years (n=96,80%) with 28 to 36 weeks period of gestation(n=66,55%).91 patients had presented with absent fetal movements(75.8%).In 25% of the cases(n=30) there was preeclampsia and in 21.6% (n=26)of the cases there were no causes determined.99.1%(n=119) delivered by vaginal route.Conclusions: The leading cause of IUFD in our study was preeclampsia. Majority of the cases were referred and they did not have regular antenatal checkups. A bigger impact in reduction of IUFD can be achieved if the importance of antenatal care can be stressed upon at the community level.
Confidential Enquiry into Maternal and Child Health (CEMACH). Perinatal Mortality 2007:United Kingdom. CEMACH: London, 2009.
World Health Organization (WHO). Neonatal and perinatal mortality, country, regional and global estimated. Department of Making Pregnancy safer. Geneva: WHO, 2004.
Silver RM, Varner MW, Reddy U. Work-up of stillbirth: a review of the evidence Am J Obstet Gynecol. 2007;196(5):433-44.
Lawn JE, Gravett MG, Nunes TM, Rubens CE, Stanton C. The GAPPS Review Group. Global report on preterm birth and stillbirth (1 of 7): definitions, description of the burden and opportunities to improve data. BMC Pregnancy Child-birth. 2010;(Suppl 1):S1,1471-2393.
Maleckiene L, Nadisauskiene R, Stankeviciene J, Cizauskas A, Bergstrom S. A case reference study on fetal bacteremia and late fetal death of unknown etiology in Lithuania. Acta Obstet Gynecol Scand. 2000;79:1069-74.
Singh N, Pandey K, Gupta N, Arya AK, Pratap C, Naik R. A retrospective study of 296 cases of intra uterine fetal deaths at a tertiary care centre. Int J Reprod Contracept Obstet Gynecol. 2013;2:141-6.
Bhati DK. Stillbirths: A high magnitude public health issue in India .South East Asia Journal of Public Health. 2013;3(1):3-9.
Patel S, Thaker R, Shah P, Majumder S. Study of causes and complications of intra uterine fetal death (IUFD). Int J Reprod Contracept Obstet Gynecol. 2014;3:931-5.
Korde NV, Gaikwad P. Causes of stillbirth. J Obstet Gynaecol India. 2008;58(4):314-7.
Okeudo C, Ezem BU, Ojiyi EE. Stillbirth Rate in a Teaching Hospital in South-Eastern Nigeria: A Silent Tragedy Ann Med Health Sci Res. 2012;2(2):176-9.
Tamrakar SR, Chawla CD.Intrauterine Foetal Death and Its Probable Causes: Two Years’ Experience in Dhulikhel Hospital – Kathmandu University Hospital Kathmandu University Hospital. Kathmandu Univ med J. 2012;10(4):44-8.
Choudhary A, Gupta V. Epidemiology of Intrauterine Fetal Deaths: A Study in Tertiary Referral Centre In Uttarakhand. Journal of Dental and Medical Sciences. 2014;13(3):3-6.
Safarzadeh A, Ghaedniajahromi M, Ghaedniajahromi M. Intra Uterine Fetal Death and Some Related Factors: A Silent Tragedy in Southeastern Iran J Pain Relief 2014;3:1.
Gold KJ, Abdul-Mumin AS. Assessment of “fresh” versus “macerated” as accurate markers of time since intrauterine fetal demise in low-income countries.Int J Gynaecol Obstet. 2014;125(3):223-7.
Ifnan F, Jameel MB. Maternal morbidity and mortality associated with delivery after intrauterine fetal death. J Coll Physicians Surg Pak. 2006;16(10):648-51.