Intrauterine Fetal Intrauterine Fetal Demise (IUFD)Demise (IUFD)

Dr. Sameer KumarDr. Sameer Kumar

Intrauterine Fetal DemiseIntrauterine Fetal Demise

Definition: Definition: is fetal death after 20 weeks’ is fetal death after 20 weeks’ gestation but before the onset of labour.gestation but before the onset of labour.

Complicates 1% of pregnanciesComplicates 1% of pregnanciesEtiology: Etiology: the cause is unknown in 50% of the cause is unknown in 50% of

casescasesKnown causes include: HTN in pregnancy, Known causes include: HTN in pregnancy,

D.M, Rh isoimmunization, fetal D.M, Rh isoimmunization, fetal congenital anomalies, umbilical cord congenital anomalies, umbilical cord accidents, prenatal infections, accidents, prenatal infections, antepartum hemorrhage, APA syndrome antepartum hemorrhage, APA syndrome and Thrombophiliasand Thrombophilias

DiagnosisDiagnosis

If the mother reports absence of fetal If the mother reports absence of fetal movements or if fetal heart tone is not movements or if fetal heart tone is not detected by doppler devise. ? Serum hCGdetected by doppler devise. ? Serum hCG

Confirmation by UltrasonographyConfirmation by Ultrasonography

ManagementManagement

Expectant approach: Expectant approach: 80% goes into 80% goes into spontaneous labour within 2-3 weeksspontaneous labour within 2-3 weeks

Active approachActive approach: b/o emotional burden, : b/o emotional burden, risk of chorioamnionitis, and 10% risk of DIC risk of chorioamnionitis, and 10% risk of DIC (if >5wks)(if >5wks)

Induction of labour can be initiated at any Induction of labour can be initiated at any time.time.

• F/U: F/U: to determine cause of death. to determine cause of death. Screening for diseases, infections (TORCH), Screening for diseases, infections (TORCH), and chromosomal anomalies. Manage next and chromosomal anomalies. Manage next pregnancies as high-riskpregnancies as high-risk