In utero fetal death
Abstract
Objectives-To give consistent data of the prevalence of intrauterine fetal death (IUFD), toassess risk factors and causes related to IUFD, to evaluate prevention of IUFD, to evaluate fetalautopsy and MRI and to determine the management of inhibition of lactation.
Methods-French and English publications were searched using PubMed, Cochrane Library.
Results.-Intrauterine fetal death occurs in 2% of the pregnancies worldwide, and in around0,5% of pregnancies in France (NP1). Major risk factors related to IUFD are maternal over-weight, maternal age, and smoking, small for gestational age fetuses or placental abruption,and pre-gestational maternal diseases such as hypertension and diabetes (NP1). The most rele-vant causes of IUFD are placental anomalies, followed by abnormal karyotypes and congenitalmalformations (NP3). Data are insufficient to recommend a classification for causes of IUFD.Data concerning primary and secondary prevention do not recommend a specific managementfor the following of pregnancy. Fetal autopsy is still the gold standard of fetal examination, butfetal post-mortem MRI can be offered when fetal autopsy is refused (NP4). Inhibition of lacta-tion should be started within 24 hours postpartum with cabergoline, if the patient demands atreatment (NP4).