A retrospective analytical study of caesarean section in intrauterine foetal death cases in a rural medical college
Keywords:Caesarean deliveries, Intrauterine fetal death, Maternal Mortality
Background: Intrauterine fetal death(IUFD) is an unhappy reality, a lamentable incidence for both the family and the caregiver. It is an important indicator of both maternal and perinatal health in a population. The study of fetal death is crucial in promoting actions for maternal and child health. Aim of this study was to determine the incidence, indications and maternal morbidity and maternal mortality associated with caesarean section in patients with IUFD and to establish the place of caesarean section in present day scenario.
Methods: The study was a retrospective analysis of all caesarean section carried out in a case of IUFD in last 5 years (2013-2017). The indications, incidence, maternal morbidity, mortality was studied well in this time period in a rural medical college of West Bengal.
Results: Total 108425 deliveries occurred in the hospital in last 5 years, out of which 31800 were caesarean section. 56 cases were done in case of diagnosed IUFD. There was 2489 number of IUFDs in the given period. The incidence of IUFD was 22.96 per 1000 deliveries. Induction was done in 2489 cases; 56 cases underwent caesarean section (2.25%) and rest was delivered vaginally.
Conclusions: Early diagnosis, early referral and proper antenatal checkup can reduce the chances of IUFD and number of caesarean deliveries in IUFD. The role of cesarean deliveries in previous caesarean deliveries having IUFDs has been emphasized.
Kowaleski J. State definitions and reporting requirements for live births, fetal deaths, and induced terminations of pregnancy (1997 revision). Hyattsville, Maryland: National Center for Health Statistics.1997. Available at: http://www.cdc.gov/nchs/data/misc/itop97.pdf.
MacDorman MF, Kirmeyer S, Wilson EC. National vital statistics reports. National Vital Statistics Reports. 2010 Mar 3;58(11).
WHO: Recommended definition, terminology and format for statistical tables related to the perinatal period and use of new certificate for case of perinatal death. Actaobstet Gyneol Scand. 1997;56(3):247-53.
Green–top Guideline No. 55. Late intrauterine fetal death and stillbirth, Royal College of Obstetricians and Gynaecologists. 2010;1-33.
National Institute for Clinical Excellence(NICE); National Collaborating Centre for Women's and Children's Health. Caesarean section. London (UK), 2004.
National Institute for Health and Clinical Excellence; Clinical guideline no. 70. Induction of labour. London. 2008.
Gómez P de LR, Wing D, Fiala C. Misoprostol for intrauterine fetal death. Int J Gynaecol Obstet. 2007;99(2):S190-3.
Nascimento MI, Cunha AD, Oliveira SR. Clinical management of the induction of labor in intrauterine fetal death: evaluation of incidence of cesarean section and related conditions. Revista Brasileira de Epidemiologia. 2014;17:203-16.
Papp Z. Fetal Demise. In: World Association of Perinatal Medicine (WAPM), Matres Mundi International. Recommendations and guidelines for perinatal medicine. Disponível em: http://www.wapm.info/Portals/0/recommendations_perinatal.pdf.
Brazil. Ministry of Health. Secretariat of Health Care. Department of Strategic Programmatic Actions. High risk pregnancy: technical manual. Brazil. 5th edition. Brasília: Publisher of the Ministry of Health. 2010:101-9.
Dodd JM, Crowther CA; Elective repeat caeserian section versus induction of labour for woman with previous caeserian birth. Cochrane Database Syst Rev. 2006;4:CD004906.
Alanis MC, Robinson CJ, Hulsey TC, Ebeling M, Johnson DD; Early onset severe prevere preeclampsia: induction of labour versus elective caesarean delivery and neonatal outcome. Am J Obstet Gynecol. 2008;199(3):262.el6.
Sampaio AG Rolland ASR; Indications of caeserian section in stillbirth. Rev Bras Gynecol Obstet. 2010;32(G):169-75.