ABSTRACT
Objective: Study was conducted to determine the rates, documented causal factors and obstetric outcome for intrauterine fetal deaths at a tertiary care centre in Gujarat. The study also aimed to prove the value of antenatal care in prevention of intrauterine fetal death. Methods: A prospective descriptive study was conducted at a tertiary hospital in Gujarat, India. The study was performed over 14 month’s period (Jun 2004 to July 2005). Patients having intrauterine fetal death on admission in the third trimester were included in this study. Total number of deliveries during this period was 9802. Among this, total numbers of antenatal IUFD in third trimester were 161. The causes of IUFD were determined purely on close clinical observations and preliminary investigations. Results: Total number of deliveries were 9802.Incidence of still birth at our centre was 31 per 1000. Antenatal IUFD rate was 16.5 per 1000 after excluding early trimester fetal deaths and intra partum fetal deaths. IUFD amounts to one third of perinatal mortality in this study. Among the identifiable causes,Hypertensive disorders (31%), placental abruption (15.5%), severe anemia (13%), were most common causes. Congenital malformations were responsible for 4.3% cases .Induction was done in 36, augmentation was done in 53 patients,67 patients had spontaneous onset of labor and caesarean section was done in 5 patients. The most devastating complication of IUFD was DIC found in 3 patients (1.9%). Conclusions: The present study is an effort to compile a profile of maternal, fetal and placental causes culminating to IUFD at our centre. This emphasizes the Importance of proper antenatal care and identification of risk factors and its treatment. Considerable number of IUFD are still labeled as unexplained, hence cannot be prevented. Decrease in the incidence of IUFD would significantly reduce the perinatal mortality.