Management of fetal death after 20 weeks of gestation complicated by placenta previa

Clinical management of the induction of labor in intrauterine fetal death: evaluation of incidence of cesarean section and related conditions

“…Firstly, it is considered convenient in the presence of IUFD and low implantation of center-total placenta. In Holland, between 1990 and 2005, this combination was reported in only three cases performed with labor induction, cesarean surgery, and expecting behavior respectively, however surgery was indicated due to PA occurrence 6 . For the Brazilian Ministry of Health 1 , the PA occurrence also constitutes a reasoning to perform the C-section due to the high risk of coagulopathy.…”

“…On the other hand, circumstances like high maceration degree of the fetal body 4 , labor obstructed by macrosomia or shoulder dystocia 5 , and center-total placenta previa 6 make the abruption of the baby harder, requiring more invasive maneuvers to finish gestation through the vaginal route. Ethical questions and psychological burden, which include performing surgeries that destroy fetal structures, discourage its indication, so for some situations the only alternative left is the cesarean section 5 .…”

Management of fetal death complicated by placenta previa during the midtrimester

“…Ploeg et al. 4. compared three cases of fetal death with placenta previa occurring at or after 20 weeks of gestation and that were treated with expectant management, induction of labor, and selective cesarean section, respectively.…”

A Dilemma in Management of Intrauterine Death in Mother with Major Placenta Previa

“…Furthermore, the risk of coagulopathy and infection will rise (8). By inducing labour in intrauterine death, approximately about 90% of women can achieve vaginal birth within 24 hours (9).…”

“…The first method is by dilatation and evacuation (D&E). It is a safe procedure with an experienced surgeon and can be done until about 24 weeks of gestation (8). Second option is by hysterotomy or caesarian section.…”