[In utero fetal death]

Abstract

Objectives: To give consistent data of the prevalence of intrauterine fetal death (IUFD), to assess risk factors and causes related to IUFD, to evaluate prevention of IUFD, to evaluate fetal autopsy 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 around 0,5% of pregnancies in France (NP1). Major risk factors related to IUFD are maternal overweight, 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 relevant causes of IUFD are placental anomalies, followed by abnormal karyotypes and congenital malformations (NP3). Data are insufficient to recommend a classification for causes of IUFD. Data concerning primary and secondary prevention do not recommend a specific management for the following of pregnancy. Fetal autopsy is still the gold standard of fetal examination, but fetal post-mortem MRI can be offered when fetal autopsy is refused (NP4). Inhibition of lactation should be started within 24hours postpartum with cabergoline, if the patient demands a treatment (NP4).

Keywords: Antepartum fetal death; Autopsie fœtale; Classification des morts fœtales; Classification of stillbirth; Fetal autopsy; Inhibition de la lactation; Intrapartum fetal death; Intrauterine fetal death; Lactation inhibition; Mort antepartum; Mort fœtale in utero; Mort intrapartum; Mort périnatale; Perte de grossesse; Stillbirth; fetal loss.