Understanding IUFD, Fetal Death in the Womb

Intrauterine fetal Death or IUFD is a condition of a fetus that dies in the womb after 20 weeks of pregnancy. Some cases of IUFD cannot be prevented, but you can reduce the risk by being aware of the cause and taking appropriate preventive steps. When a baby is born, but there are no signs of life, such as breathing, heart rate, or body movements, the baby is said to experience stilbirth or stillbirth. In stillbirth, the baby may die during labor (intrapartum death), or the baby has indeed died while still in the womb or in the mother's womb. The condition of a fetus that has died since he was in the womb when the gestational age is over 20-28 weeks is called IUFD. Each doctor may use different fetal age criteria in determining the classification of IUFD. Another criterion for declaring IUFD is when the fetus dies it has weighed more than 350 grams in the uterus. IUFD is different from miscarriage, in which fetal death occurs when the gestational age has not reached 20 weeks.

Factors Causes IUFD

The majority of cases of IUFD are not clearly known the cause, but can be a sign of a problem in pregnancy. Various possible factors causing IUFD include:

• Placental factor

One cause of IUFD is a placenta that is not functioning properly. Disruption of the placenta makes the distribution of essential nutrients needed by the fetus during the womb, such as blood flow and oxygen, to be blocked and reduced. As a result, can cause fetal development (intrauterine growth restriction / IUGR) and lead to fetal death in the womb (IUFD).

• Genetic defects

One other cause of IUFD is genetic defects or chromosomal abnormalities that cause the vital organs of the fetus, such as the brain and heart, to not develop properly.

• Bleeding

Severe bleeding that occurs at the end of the last trimester of pregnancy can also be a cause of fetal death in the womb. This can occur when the placenta has begun to separate (decay) from the uterus before entering labor. This condition is called placental abruption.

• Mother's health condition

Diabetes and hypertension in pregnancy, autoimmune conditions, malnutrition, bacterial infections such as group B Streptococcus, listeriosis, toxoplasmosis, and rubella, can cause fetuses to die in the womb. Likewise with other infections, such as malaria, syphilis, and HIV. Preeclampsia can also reduce blood flow to the fetus through the placenta, and ultimately cause IUFD due to interference with the placenta.

• Age and lifestyle factors

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

Management of IUFD

In contrast to miscarriages which are generally performed by a curette procedure to remove a deceased fetus, the fetus in the case of IUFD is excreted through labor, either by induction or natural delivery. The delivery process can be delayed one to two days while waiting for the natural delivery process. But if maternal health is at risk, the fetus needs to be born as soon as possible. Although it rarely happens, the fetus dies in the womb sometimes need to be born by cesarean section. In twin pregnancies, if one fetus experiences IUFD, then induction labor is generally not recommended. The doctor will examine the condition of other fetuses and recommend actions that are appropriate to the condition of the mother and fetus. Generally, keeping the two fetuses in the womb until delivery time is recommended by many doctors. To find out the cause of fetal death in utero, physical examination is needed, accompanied by maternal blood examination, ultrasound, placental examination, fetal genetic examination, and post mortem examination or baby autopsy. Fetal death in the womb can indeed leave a separate trauma for the mother. It usually takes time for a mother to bounce back from feeling sad after losing her fetus. After an IUFD occurs, the expectant mother will physically experience vaginal bleeding and express milk which may be uncomfortable. To stop the production of breast milk, the doctor will give certain medicines.

Preventive Measures for IUFD

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

• Do not smoke during pregnancy.
• Do not consume alcoholic drinks and dangerous drugs during pregnancy. It can affect fetal development, and increase the risk of miscarriage, and stillbirth.
• Avoid sleeping on your back when you are 28 weeks or older.
• Routine pregnancy checks to the obstetrician or midwife to monitor the growth and development of the fetus and ensure the health condition of the mother and fetus during pregnancy.

If the mother and fetus have risk factors for causing IUFD, consult a doctor. If you find any unusual signs, for example the intensity of fetal movement decreases, immediately see an obstetrician to get an examination and treatment.