Determinations of antepartum fetal death

Objectives: This study was conducted to analyze the maternal and fetal etiologies of intrauterine fetal death, and to assess the diagnostic accuracy of an antenatal ultrasound, in the year 2007-208, at Lady Goschen Hospital, Mangalore. Methods: The study is a prospective, non interventional, observational study, with 28 women as the subjects.Women admitted to the labor room with intrauterine fetal death, were counseled for fetal autopsy after delivery.Written and informed consent was taken from the couple for the autopsy examination, and fetus with the placenta was sent to Kasturba Medical College, Pathology Department for histopathology. Results: Peak incidence was seen among the women 25-30 years of age with most of them being gravida two (46.43%). Maternal hypertensive disorders (28.56%) and fetal anomalies (32.14%) were the most common associations with fetal death. Unexplained etiology of fetal death was associated with gestational age of 36 weeks or more (75%), mostly in primigravida (43%), with fewer than four antenatal visits. Ultrasound was able to detect 55.55% of fetal anomalies antenatally. Conclusions: Fetal autopsy is a must in accurately diagnosing the cause of fetal death. This has a bearing on the future pregnancy with respect to risks of recurrence.