Incidence and Risk Factors for Intrauterine Foetal Demise: a Retrospective Study in a Tertiary Care Centre in India

Abstract

Objective: To determine the incidence and possible causes of Intrauterine Foetal Demise (IUFD), and to determine preventive measures. Methods: Retrospective observational study was done from Jan 2015 to Dec 2015 at the tertiary care referral hospital in Bangalore, India. Inclusion criteria were IUFD at or above 24weeksof gestation. The parameters analysed were maternal age, parity, probable causes for IUFD, booked or unbooked cases, mode of delivery, maternal complications, and placental histopathology. Data were analysed using SPSS version 23. Results: The incidence of IUFD at our hospital was 39/1000 live births. The IUFD rate was similar in maternal age <20years and >30years (p value 0.26). The incidence of IUFD increased with decreasing gestational age which was statistically significant (p value 0.001). IUFD incidence was higher in multiparous women compared to primiparous women (p value 0.036 with OR of 1.6 and 95% CI 1.02 to 2.54). The rate of IUFD was similar when sex of the baby was analysed. 49.4% of foetuses had signs of maceration. The major cause of IUFD was severe preeclampsia (48.1%) which included HELLP syndrome, IUGR, Abruption. Maternal anaemia (20.4%), GDM (3.8%), SLE (2.5%), APLA positive (2.5%), anhydramnios (6.3%) were some of the other important causes of IUFD. Conclusion: This study was conducted to determine the incidence of IUFD and associated maternal risk factors. By understanding the contributing factors, we can seek ways of avoiding recurrence of IUFD by proper antenatal care and early diagnosis of obstetric complications and its appropriate management.