Introduction
Fetal death is defined as the delivery of a fetus showing no signs of
life as indicated by the absence of breathing, heart beats, pulsation of
the umbilical cord, or definite movements of voluntary
muscles.1It is divided in early (<22 weeks
of gestation), intermediate (between 22 and 27 weeks of gestation) and
late (> 28 weeks of gestation) depending on gestational
age. Of these, early are designated as abortions whereas intermediate
and late are known as stillbirths.1
Intrauterine fetal death (IUFD) at any time during pregnancy is
devastating for the expecting couple as well as their families and it is
at such times that issues like the cause of the death of the fetus and
the fear of recurrence of such mishap in future pregnancies crop up.
These are major concerns for the couples as well as care givers; hence
the determination of cause and mechanism of death is important to
facilitate counseling of parents, management of subsequent pregnancies
and future interventions if possible. However majority of times these
questions remains unanswered due to several underlying factor and hence
counseling parents is often unsatisfactory.
Despite these limitations of ascertaining the precise cause it is
important to identify etiological factors that might themselves
contribute in IUD or can be indicative of other factors that can play a
significant role in IUD. The causes include maternal, fetal, placental
lesions, cord accidents and genetic causes that should be investigated
as per ACOG guidelines as a part of postmortem investigation of
intrauterine death.2In the present study we have
analysed 100 cases of IUFD. Our primary objective was to calculate the
importance of various investigations in systematic postmortem
examination protocol. This will help the obstetrician in counselling
parents for the utility of post-mortem excamination and thus better able
to guide for future recurrence risk. Such protocol based evaluations are
much needed in our country as India is listed as a country with highest
number of still birth.