Intra Uterine Fetal Death

🫀 Intra Uterine Fetal Death (IUFD)

Intra Uterine Fetal Death (IUFD) is an important obstetrics topic for nursing and medical students. These IUFD nursing notes explain the definition, causes, types, signs and symptoms, diagnosis, management, prevention, and complications of IUFD in simple language for exams and clinical understanding.

Introduction

Intra Uterine Fetal Death (IUFD) refers to the death of a fetus in the uterus after 20 weeks of gestation but before birth.

• Death of fetus before 20 weeks is called "Abortion".
• If fetus dies during delivery, it is called "Still Birth".

Definition

IUFD is confirmed when the fetus is dead in the uterus, usually verified via ultrasound or fetal heart monitoring. In some cases, the pregnancy is no longer visible.

Types of IUFD

Based on Gestational Age:

• Early IUFD: 20–27 weeks
• Late IUFD: 28–36 weeks
• Term IUFD: ≥38 weeks

Based on Cause / Progression:

• Chronic IUFD: Slow fetal death due to conditions like placenta insufficiency.
• Acute IUFD: Sudden fetal death, e.g., placental abruption or cord prolapse.
• Spontaneous IUFD: Random fetal death without identifiable cause, e.g., blood clot or anomaly.

Incidence

Approximately 6 per 1000 pregnancies experience IUFD.

Etiology & Causes

IUFD may result from maternal, fetal, or placental causes:

A. Maternal Causes

• Hypertensive disorders
• Diabetes during pregnancy
• Maternal infections: Malaria, Hepatitis, Influenza, Toxoplasmosis, Syphilis
• Hyperpyrexia (Temp > 39.7°C)
• Post-term pregnancy & advanced maternal age
• Thrombophilias or bleeding disorders
• Trauma or accidents
• Obesity, abnormal labor, antiphospholipid syndrome

B. Fetal Causes

• Chromosomal abnormalities (trisomy 13, 18, 21)
• Fetal infections
• Rh incompatibility
• Congenital anomalies
• Intrauterine growth restriction (IUGR)

C. Placental Causes

• Placenta previa or abruption
• Uteroplacental insufficiency
• Cord accidents: true knots, prolapse
• Chorioamnionitis
• Twin-to-twin transfusion syndrome (TTTS)

Signs & Symptoms

Maternal

• Decreased fetal movement
• Fever, chills, abdominal/back pain
• Vaginal bleeding
• Nausea/vomiting
• Dark brown amniotic fluid

Fetal

• Absence of heartbeat
• Decreased movement
• Fetal distress or anomalies

Diagnosis

• Physical examination
• Ultrasound & fetal heart monitoring
• No-stress test & sonography
• X-ray of abdomen
• CBC, urine tests, TSH

Complications

• Psychological distress
• Infertility
• Shock, cardiac arrest, respiratory failure
• Bleeding & infection

Management

Medical Management

• Antibiotics
• Analgesics
• Hormonal therapy
• Blood transfusion

Surgical Management

• Hysterectomy
• Cesarean section / LSCS
• Medical induction with mifepristone + prostaglandin or misoprostol

Prevention

• Regular prenatal care
• Healthy lifestyle
• Managing medical conditions
• Avoid infections & harmful substances
• Stress reduction & adequate rest

Health Education

• Educate women about IUFD signs & prenatal care
• Encourage genetic counseling for recurrent cases
• Support groups for affected women
• Promote healthy lifestyle & stress management

💡 Student Tip: Highlight key terms (IUFD, Early IUFD, Late IUFD) for faster revision.

References

• Obstetrics by D.C. Dutta, JeePee Publication
• Midwifery and Gynecology by Preeti Agarwal
• Meta AI

*The End*

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Frequently Asked Questions (FAQs)

What is IUFD?

IUFD means intra uterine fetal death, which is the death of a fetus after 20 weeks of pregnancy before birth.

What are the common causes of IUFD?

Common causes include maternal hypertension, diabetes, placental abruption, infections, and fetal anomalies.

How is IUFD diagnosed?

IUFD is diagnosed by ultrasound, absence of fetal heart sounds, and fetal heart monitoring.