Intrauterine fetal demise-a tragic event: a study of its epidemiology, causes and methods of induction

Abstract

Background: Fetal death is a tragedy that causes severe distress to parents and caregivers. Most babies are born healthy, but sometimes, something goes wrong and a baby dies in utero. Present study was conducted to understand the incidence, epidemiological and etiological factors of intrauterine fetal death. Also to study the efficacy of misoprostol and dinoprostone as inducing agents in these cases.Methods: Present study was conducted in the Department of Obstetrics &Gynaecology, M.G.M. Medical College and Associated M.Y. Group of Hospitals, Indore (MP). Pregnancies diagnosed with IUFD were studied from March 2014 to February 2015. A total of 200 cases were studied. Ante partum events leading to fetal demise were recorded, socio-demographic and clinical characters were noted. Induction delivery interval of inducing agents was compared.Results: Incidence of IUFD at our centre was found to be 50 per 1000 deliveries. There was a high incidence in low socioeconomic strata, unbooked cases, primigravidas, preterm with abruption were the leading causes. Misoprostol was found to be more effective in termination of pregnancy in these cases .The induction delivery interval with Misoprostol was 9.64 hrs and that of dinoprostone was 12.63 hrs.Conclusions: Socio- demographic factors like poor socioeconomic class, teenage pregnancy, poor nutrition, lack of health education need to be considered as predisposing factor for prenatal deaths, many of the causes of intrauterine deaths are preventable like abruption hypertensive disorders which can be avoided by proper antenatal care. Misoprostol is cheaper and has a less induction delivery interval; it can be safely used in cases of IUFD.