Intrauterine Fetal Demise

WHAT YOU SHOULD KNOW:

Intrauterine fetal demise is the loss of a fetus (unborn baby). It is also called stillbirth or fetal death. Stillbirth occurs when a woman is 20 or more weeks pregnant.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • You may have blood clotting problems if you keep a stillborn fetus inside you. You may also get an infection. These problems can be life-threatening. If you are pregnant with more than 1 baby, a stillbirth can be dangerous to the other unborn baby or babies. Other unborn babies may need to be delivered right away. Side effects of medicine used for treatment include heavy bleeding, pain, and fever. You may also vomit or have diarrhea.

  • Risks of inducing labor include infection, damage to the uterus, and heavy bleeding. If you lose too much blood, you may need a blood transfusion. Tissue may be left in the uterus after the fetus is delivered. Caregivers may need to do a dilation and curettage procedure to remove this tissue. Risks of extra-amniotic Foley catheter induction include nausea, vomiting, diarrhea, fever, and headache. It may also damage the uterus. Risks of dilation and evacuation or curettage procedures include bleeding, infection, and damage to the uterus or cervix.

WHILE YOU ARE HERE:

Tests:

Caregivers will try to find the cause of the stillbirth. This information is important because it can answer your questions about the stillbirth, and may be used to help plan a future pregnancy. Even with testing, caregivers may not be able to find the cause of the stillbirth, but the results of the tests can still be helpful.

  • Physical exam and history: Your caregiver will examine you and ask about your health and pregnancy histories.

  • Blood tests: These tests check for problems that can cause stillbirth. Blood tests can also check for diseases that can cause stillbirth, such as syphilis.

  • Urine tests: These tests may be done to check for drug use.

  • Amniotic fluid sample: A sample of the fluid that surrounds your fetus is taken. This is done by inserting a needle into your belly to draw the fluid.

Tests done on the fetus:

  • Fetal autopsy: The fetus is examined to find the cause of death. Ask caregivers to tell you more about an autopsy.

  • Tissue tests: The placenta and umbilical cord are closely examined. Fetal blood may also be tested. Tissue tests can help find infection, blood clotting problems, and genetic problems.

  • Imaging tests: X-rays may be done. X-rays take pictures of the fetus. An ultrasound or MRI may also be done.

Treatment:

You may naturally deliver the fetus. You may need medicine or a procedure to remove the fetus from your body. Caregivers will talk to you about the following options:

  • Medical induction of labor: Medicine is used to start labor and you deliver the fetus naturally.

  • Extra-amniotic Foley catheter induction of labor: A catheter (rubber tube) is inserted into the cervix. Medicine goes through the catheter. The medicine prepares the cervix for labor, or starts contractions (tightening of the uterus). The fetus is delivered through the vagina.

  • Dilation and evacuation (D and E): The cervix (opening to the uterus) is dilated, or made larger. The fetus is then removed through the vagina (birth canal).

  • Dilation and curettage (D and C): The cervix is dilated, and caregivers use tools to remove the fetus through the vagina.

Coping after stillbirth:

You and those around you may feel sad, helpless, guilty, or angry. The following may help you and others cope after a stillbirth:

  • Talk about your experience: It may help you to talk to someone about your feelings. Talk to your caregiver. He may be able to help you understand what happened. Talk with a family member, friend, or someone you trust. You may also want to join a support group. This is a group of people who have also had a stillbirth.

  • Give yourself time to grieve: Allow yourself and others time to mourn the loss of your baby. Deep sadness is common after a stillbirth. Talk to your caregiver if you or those around you are having trouble coping. Counseling (talk therapy) may be helpful.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Intrauterine Fetal Demise (Inpatient Care)

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