Intrauterine fetal demise-a tragic event: a study of its epidemiology, causes and methods of induction
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20161008Keywords:
Intrauterine fetal demise, IUFD, Dinoprostone, MisoprostolAbstract
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.Metrics
References
Revision of the procedures for coding cause of fetal death ICD-10 Mortality manual 2013. Available at http://www.who.int/reproductivehealth/topics/maternal_perinatalet/stillbirth/en. Accessed on 25 February 2016.
ACOG Issues New Guidelines on Managing Stillbirths. Available at http://www.acog.org/About-ACOG/News-Room/News-Releases/2009/ACOG-Issues-New-Guidelines-on-Managing-Stillbirths. Accessed on 25 February 2016.
National vital statistics reports. Volume 60, Number 8 August 28, 2012. Fetal and Perinatal Mortality, United States, 2006.
Estimates of mortality indicators-Census of India website-vital statistics. Chapter 4, Pg 81, statement 51, 2010.
Censusindia. Available at. Censusindia.gov.in/vital_statistics/srs/Chap_4_-2010.pdf. Accessed on 25 February 2016.
Choudhary A, Gupta V. Epidemiology of intrauterine fetal deaths: a study in tertiary referral centre in Uttarakhand. IOSR J Dent Med Sci. 2014;13(3):3-6.
Singh N, Pandey K, Gupta N, Arya AK, Pratap C, Naik R. A retrospective study of 296 cases of intra uterine fetal deaths at a tertiary care centre. Int J Reprod Contracept Obstet Gynecol. 2013;2(2):141-6.
Biswas T. Misoprostol (PGE1) versus dinoprostone gel (PGE2) in induction of labour in late intra uterine fetal death with unfavourable cervix: a prospective comparative study. Int J Reprod Contracept Obstet Gynecol. 2015;4(1):35-7.
Agrawal N, Gupta A, Kriplani A, Bhatia N. Six hourly vaginal misoprostol versus intracervical dinoprostone for cervical ripening and labor induction. J Obstetr Gynaecol Res. 2003;29(3):147-51.
Hofmeyr GJ, Gülmezoglu AM, Pileggi C. Vaginal misoprostol for cervical ripening and induction of labour. Cochrane Database of Systematic Reviews 2010;10:CD000941.
Batool S. Comparison of oral misoprostol for induction of labour in primigravidas and multigravidas. Asian J Pharm Clin Res. 2013;6(2).
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