Dating intrauterine fetal demise Intrauterine Fetal Death and Stillbirth: Guidelines for Investigation

Dating intrauterine fetal demise

Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. Am J Obstet Gynecol; A Kleihauer-Betke fetal cell count may be drawn for evaluation.

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The rest are due to obstetric intrapartum events such as cord prolapse, shoulder dystocia or severe birth trauma. The data on the risk of stillbirth in women with inherited thrombophilias is conflicting; retrospective studies as well as a meta-analysis have reported an increased stillbirth risk associated with the factor V Leiden mutation, GA prothrombin mutation, and antithrombin III and protein S deficiencies.

Antenatal testing does not reliably predict fetal well-being and the mechanism behind the higher rates of stillbirth in this condition are not well understood. These pregnancies are at high risk of congenital anomalies, abnormalities in fetal growth and abnormal labor progression. Maternal care Fetal growth restriction: Uterine artery Doppler assessment has been evaluated for early prediction of placental insufficiency. In review of 30, studies of unselected women from across the United Kingdom, abnormal uterine artery Doppler predicted the risk of stillbirth due to placental etiologies versus the unexplained intrauterine fetal deaths.

Clinical Review: Obstetrics

Home About Disclaimer Privacy Contact. Some women may find it emotionally difficult to make a decision at the time of diagnosis, and there is no urgency to delivery.

Therefore, postmortem, placental examination, cytogenetic analysis and fetal maternal hemorrhage testing at time of induction should be offered in all stillbirths. Amniotic band sequence Cervical insufficiency Chorionic villus sampling Cigarette smoking: Evaluation of placenta and the umbilical cord also are important and may propose datings intrauterine fetal demise of dating intrauterine fetal demise such as abruption, vasa previa or umbilical cord vessel thrombosis. A difficult decision may arise when a woman has a prior uterine scar and fetal demise.

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This risk, however, increased, if placental abruption or uterine perforation was present. Int J Gynaecol Obstet ; Management Antepartum Intrapartum Postpartum 4.

In this study, the authors determined how often a perinatal autopsy was able to establish the cause of death. When the question of fetal death arises during labor, an internal fetal monitor can be applied to the presenting part. Obstetrical issues and management Pregestational diabetes: Systemic lupus erythematosus SLE carries an elevated stillbirth rate of per 1, births. What every clinician should know Epidemiology Risk factors Pathogenesis 2. It should be noted that parent groups prefer the term stillbirth to the other terms.

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Further sequential testing is indicated based on the results of this basic evaluation as well as the specific clinical circumstances accompanying the stillbirth. The risk of stillbirth is higher in multiple gestations, largely due to the placental abnormalities, especially in the monochorionic pregnancies. Patients found to have these antibodies in high titers 99th percentile appear to have an elevated risk of stillbirth, although the extent of this risk is unknown.

In addition it is hoped that families will be provided with information about the cause of death, as well as emotional guidance.

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Alloimmunization red cell or plateletalthough rare, is associated with a risk of stillbirth. If the pregnancy is uncomplicated, induction of labor can be scheduled for 39 weeks gestation. What is the evidence for specific management and treatment recommendations. Histologic evaluation of the placenta is not always helpful given the clinical nature of the diagnosis; however, infarction, thrombosis, and hemosiderin deposits consistent with chronic abruption may be present.


Causes of death among stillbirths. If untreated, the risk of stillbirth is very high.

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Multiple studies report poor maternal glycemic control as a finding in women with stillbirth, with overall increased risk of 2. Part of the risk is attributable to higher rates of preterm birth, fetal growth restriction and maternal medical complications hypertension, gestational diabetes seen in pregnancies with multiple gestations. This can occur due to cord entanglement nuchal intj istj dating, true knots, or cord entanglement seen in monochorionic, monoamniotic gestationsor thrombosis of vessels coursing in the cord.

Haywood Brown and Peter Nielsen.