The clinical predictors of intrauterine fetal death

Five hundred and thirteen (513) patients with intrauterine fetal death managed between 1983 and 1990 at Hacettepe University Hospital were analyzed retrospectively. Fetal death rate was 20.5/1,000 deliveries during the study period. The mean age of the mothers at diagnosis was 27.6 years. Of the 326 multigravida patients, 113 (34.6%) had a history of abortion and 113 had a history of previous intrauterine fetal death. The leading causes of intrauterine fetal death in this series were maternal hypertension in 167 patients (32.5%) followed by abruptio placentae in 38, Rh incompatibility in 30 and congenital anomalies in 30 patients. However, in 175 patients (34.1%), the cause of intrauterine fetal death could be explained. Three mothers were lost: one from pulmonary embolism complicating deep venous thrombosis, one from heart failure due to rheumatic disease, and one from cerebral injury following a traffic accident. The patients with a history of fetal demise should be managed under high risk category with close antepartum surveillance, especially in the last trimester, so as to reduce intrauterine fetal deaths which are mostly attributable to preventable causes.