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Fetal death in the third trimester of pregnancy
Some women experience fetal death in the third trimester of pregnancy and have the right to receive answers, as this is a traumatic experience for the mother, with psychological and social repercussions and can lead to depression and post-traumatic stress disorder.
What are the causes of intrauterine fetal death?
** Placental dysfunction, which causes fetal anoxia and stunted growth.
** Chronic health problems in the mother, such as diabetes, high blood pressure, thyroid dysfunction, etc.
** Harmful daily habits practiced by the mother: smoking, drug use, alcohol consumption.
** Certain genetic/chromosomal problems.
**Congenital abnormalities in the fetus
**Maternal obesity
**Poor social/financial status of the mother and living in poor, deprived areas
**Bacterial/viral infections affecting the mother/fetus during pregnancy
**Blood clotting factors and the presence of antibodies in the mother
How is intrauterine fetal death diagnosed?
Ultrasound (absence of fetal heartbeat) is used. The diagnosis must be confirmed by two doctors.
What is the next step after an intrauterine fetal death is diagnosed?
** Tests are performed to ensure the mother's well-being and to ensure there are no health risks.
** Tests are performed to determine the cause of intrauterine fetal death.
What is the importance of knowing the cause of intrauterine fetal death?
**To provide answers to parents and family, thus alleviating their psychological/emotional burden.
**To explore modifiable causes to prevent the same scenario from recurring in subsequent pregnancies.
**To learn how to cope with subsequent pregnancies and what tests should be performed before/during pregnancy.
Is it necessary to give birth immediately after a diagnosis of intrauterine fetal death?
It depends on the cause and the mother's general condition. If there is no threat to the mother's health, we can wait between 48 hours and four weeks. However, it should be noted that waiting too long increases the risk of serious complications for the mother, such as blood clots and organ failure.
Does the delivery have to be by cesarean section?
No, delivery is vaginal unless there is a medical reason for a cesarean section.
What is the recommended spacing period between pregnancies after intrauterine fetal death?
6-12 months
If a woman has previously experienced intrauterine fetal death in the third trimester, at what stage should she deliver in subsequent pregnancies?
39 weeks of pregnancy, unless there is a medical reason for early delivery.
What advice do we give to a woman who has experienced intrauterine fetal death and whose cause is unknown?
** Weight loss if obese
** Quitting smoking/drinking alcohol
** Taking 60-150 mg baby aspirin in subsequent pregnancies before the 16th week of pregnancy
** Testing for acquired clotting factors
**Thyroid tests
**Gestational diabetes screening and blood pressure monitoring
**Chromosomal/genetic testing for the parents if suspected
**Blood type and red blood cell antigen (RBC) immunological factors should be confirmed
**Psychological support and counseling should be provided to the couple and their family members after this experience, given the severe psychological impact it can have
Dr Najeeb Layyous F.R.C.O.G
Consultant Obstetrician, Gynecologist and Infertility Specialist
