Fetal death: diagnosis and management

Area of Science:

• Perinatology
• Reproductive Medicine
• Medical Diagnostics

Background:

• Fetal death after 20 weeks gestation, or stillbirth, affects approximately 1% of all pregnancies.
• Accurate diagnosis of fetal demise is crucial for appropriate management.
• Identifying the cause of stillbirth is important for genetic counseling and recurrence risk assessment.

Purpose of the Study:

• To review the diagnostic methods for fetal death.
• To discuss the management of fetal demise.
• To highlight specialized tests for identifying causes of unexplained stillbirth.

Main Methods:

• Real-time ultrasound for fetal heart visualization.
• Prostaglandin vaginal tablets for fetal demise induction.
• Karyotyping, listerial culture, fetomaternal hemorrhage assessment, and lupus anticoagulant testing for etiological investigation.

Main Results:

• Real-time ultrasound is the most accurate method for diagnosing fetal life or death.
• Prostaglandin vaginal tablets are a simple and effective method for fetal demise induction, particularly before 28 weeks.
• Known causes account for only 50% of stillbirth cases; specialized tests can identify causes in the remaining 50%.

Conclusions:

• Timely diagnosis and effective management of fetal death are essential.
• Specialized testing plays a vital role in elucidating the etiology of unexplained stillbirths.
• Understanding the causes of stillbirth aids in future pregnancy risk assessment and counseling.