Risk Factors Related to Intrauterine Fetal Death

Abstract

Background: Intrauterine fetal death is a traumatic event. Stillbirth rate is an important indicator to assess the quality of antenatal care. The objective of the study was to identify the risk factors related to intrauterine fetal death in patients admitted with intrauterine fetal death.Methods: It was a descriptive study conducted in the department of Obstetrics and Gynaecology at B. P. Koirala Institute of Health Sciences from January to December 2014. Patients admitted with singleton pregnancy with intrauterine fetal death after 28 weeks gestation were included. Results: There were 11,006 obstetric admissions. Of them, 152 women had intrauterine fetal death. There were 128(84.2%) women between 20-35 years of age. Out of 152, 81(53.3%) women were preterm and 39(2.1%) women were postterm. Primigravida were 77(50.7%) followed by 35(23%) of second gravida. Hypertension was the commonest identified risk factor in 30(26.78%) women. Out of 152 women, 49(32.2%) had not received formal education. Ten (6.6%) women had a past history of fetal death. Four (2.6%) women had medical disorder before pregnancy. One hundred and twenty five (82.2%) women had vaginal delivery, 21(13.8%) had caesarean section and 6(3.9%) had laparotomy for rupture uterus. The commonest indication for caesarean section was placenta previa for 7(33.33%) women. Four (2.6%) women had diabetes. Ninety five (62.5%) were male and 57(37.5%) were female babies. Five (3.3%) babies had malformations. Conclusions: Hypertension in pregnancy was found to be the most common identified risk factor for intrauterine fetal death. Keywords: Fetal death; pregnancy; risk factors.

Factors Related to Late Intrauterine Fetal Death in a Tertiary Referral Center: A Retrospective Study

“…A relatively high number of patients had no identified risk factors. 13 Similar studies conducted in different health care centers of Nepal also found hypertension as a significant risk factor for IUFD. 4,14 Noteworthy, our study also showed similar results with a high incidence of hypertension complicating pregnancy followed by heart disease in mothers.…”

“…This result is consistent with the findings of the study by Shrestha et al and Thakur et al where 66.67% and 53.3% of the babies born were preterms respectively. 13,20 A similar study done in Nepalgunj Medical College showed 63.07% of the cases of IUFD were preterm and it is a significant risk factor for IUFD. Congenital malformations were evident in four cases of IUFD and are also shown to be significant risk factor for IUFD in previous studies.…”

“…This result is comparable to studies done on BPKIHS and Dhulikhel hospital in which IUFD was seen more in primigravida and incidence of IUFD gradually decreased as the parity increased. 4,13 This may be due to the level of knowledge about pregnancy and pregnancy-related care that the mother acquired on previous pregnancies.…”

“…Congenital malformations were evident in four cases of IUFD and are also shown to be significant risk factor for IUFD in previous studies. 13,14,21 When a Rh-negative mother is exposed to Rh-positive blood either through previous pregnancies or blood transfusion, she develops anti-D antibody (IgG) type which can cross the placental barrier causing fetal hemolysis.22 This is a significant risk factor of death of a fetus in utero. In our study out of 46 cases of IUFD, two mothers had Rh incompatibility.…”

“…This helps in identification of the high risk population along with reduction of interventions required. 13…”