Etiologies of intrauterine fetal death

Background: Intrauterine fetal death accounts for more than half of perinatal mortalities. Detection of causes of fetal death can lead to prevention of such events in further pregnancies and produce useful information to other members of the family. Objective: To identify the causes of intrauterine fetal death and also detecting the contributing role of fetal, maternal and placental abnormalities in such conditions. Methods: This was a descriptive study carried out at Tehran Javaheri hospital over a 7-year period (1996-2003). All cases of intrauterine fetal death in which the subjects were older than 20 weeks of gestation were studied. Data were collected using patients medical records. Following evaluation of objective variables, the data were analyzed by SPSS 11 and descriptive statistics. Findings: The highest percentage (42.5%) of IUFD causes were due to placental and fetal cord abnormalities followed by fetal (16%), maternal (14.5%) and unknown (27%) causes. Among known causes, congenital fetal anomalies were the highest. Abruption of placenta and diabetes in mothers were the most causes of IUFD associated with the placental and maternal causes, respectively. Conclusion: Regarding the high rate of unknown causes (27%) found in our study, detection of causes of fetal death through autopsy procedure, cytologic examination and parvovirus B19 evaluation is recommended. Mothers with past history of IUFD should be screened for antiphospholipid antibodies titer. Also a triple test including (alfa-fetoprotein, unconjugated striol and HCG) must be performed for all pregnant women during the 15th to 20th weeks of gestation to detect the presence of any congenital anomalies