Intrauterine fetal Death or IUFD is a fetal condition that died in the womb after 20 weeks' gestation. Some cases of IUFD can not be prevented, but you can reduce the risk by being wary of the cause and taking appropriate precautions.

When the baby is born, but there are no signs of life, such as breathing, heartbeat, or body movement, the baby is said to have stilbirth or stillbirth. In stillbirth, the baby may die while in the process of labor (intrapartum death), or the baby is already dead while still in the womb or in the mother's womb.

The condition of a fetus who has died since he was in the womb when the gestational age is over the age of 20-28 weeks is called IUFD. Each doctor may use different fetal age criteria to determine the classification of IUFD. Another criterion for declaring an IUFD is when the fetus dies has reached more than 350 grams of weight in the womb. IUFD is different from a miscarriage, which fetal death occurs when the gestational age has not reached 20 weeks.

Factors Cause Occurrence of IUFD

Most cases of IUFD are not known clearly the cause, but can be a sign of problems in pregnancy. Various possible causes of IUFD include:

• Placental factors

One of the causes of IUFD is that the placenta is not functioning properly. Disorders of the placenta make channeling the essential nutrients the fetus needs during the womb, such as blood and oxygen flow, becomes blocked and reduced. As a result, it can cause an intrauterine growth restriction (IUGR) and lead to fetal death in the womb (IUFD).

• Genetic defects

One other cause of IUFD is a genetic defect or chromosomal abnormality that causes the vital organs of the fetus, such as brain and heart, not well developed.

• Bleeding

Severe bleeding that occurs in late trimester gestation can also be the cause of a dead fetus in the womb. This can happen when the placenta begins to separate (decay) from the uterus before entering into labor. This condition is called placental abruption.

• Maternal health conditions

Diabetes and hypertension in pregnancy, autoimmune conditions, malnutrition, bacterial infections such as Group B Streptococcus, listeriosis, toxoplasmosis, and rubella, can be the cause of the fetus in utero. So do other infections, such as malaria, syphilis, and HIV. Preeclampsia can also reduce blood flow to the fetus through the placenta, and eventually cause IUFD due to placental disturbances.

• Age and lifestyle factors

Other factors that increase the risk of IUFD is the age of pregnant women over 35 years or less than 15 years, pregnant women are obese, consume alcoholic beverages, or smoking during pregnancy. Smoking can limit the growth of the fetus in the womb because it reduces the supply of oxygen to the fetus through the placenta.

Some experts also suggest that the fetus is stillborn or the fetus dies in the womb is often caused by a combination of a number of factors above, such as placental disorders, maternal health, and poor lifestyle.

Handling of IUFD

In contrast to a miscarriage that is generally done curette procedure to remove a deceased fetus, the fetus in the case of IUFD is released through labor, either induced or natural labor. The birth process can be delayed one to two days while waiting for the birth process naturally. But if the health of the mother at risk, then the fetus needs to be born as soon as possible. Although rare, the fetus dies in the womb sometimes needs to be born by cesarean section.

In a twin pregnancy, if one of the fetuses has an IUFD, then induction of labor by way of induction is generally not recommended. The doctor will examine other fetal conditions and advocate for actions appropriate to the condition of the mother and fetus. Generally, keeping the two fetuses fixed in the womb until the time of labor arrives is recommended by many doctors.

To determine the cause of fetal death in the womb should be done physical examination, along with maternal blood tests, ultrasound, placental examination, fetal genetic examination, and post mortem examination or infant autopsy.

Fetal death in the womb can indeed leave a trauma for the mother. It usually takes time for the mother to bounce back from grief after losing her fetus. After the IUFD occurs, physically expectant mothers will experience vaginal bleeding and breastfeeding that may be uncomfortable. To stop the production of breast milk, doctors will give certain drugs.

IUFD Prevention Steps

Although not all cases of IUFD can be prevented, but pregnant women can do several things to reduce the risk of IUFD, among others:

• No smoking during pregnancy.

• Not consuming alcoholic beverages and harmful drugs during pregnancy. It can affect fetal development, and increase the risk of miscarriage, and stillbirth.

• Avoid sleeping supine at the age of pregnancy entering 28 weeks or more.

• Routine performing a pregnancy examination to a gynecologist or midwife to monitor fetal growth and ensure the health condition of the mother and fetus during pregnancy.

If the mother and fetus have a risk factor causing IUFD, consult a physician. If you find any unusual signs, such as the intensity of fetal movement decreases, see an obstetrician immediately to get an examination and treatment.
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