Intrauterine Fetal Demise

Intrauterine fetal demise (IUFD), or stillbirth, is the medical term for a baby that dies in the womb after the 20th week of pregnancy. Intrauterine fetal demise is never the desired outcome of a pregnancy, but it can happen for a variety of reasons such as a genetic disease or infection.

Intrauterine Fetal Demise Explained

Intrauterine fetal demise the medical term for a child who dies in utero after the 20th week of pregnancy. IUFD rates are low. According to the National Vital Statistics Report from 2006, the rate of IUFDs is 6.05 per 1000 births or less than 1%.

While doctors and parents may never know what caused an IUFD, some risk factors can increase the chances of it occurring. These include multiple fetuses, genetic conditions, mother’s age and the pregnancy lasting for more than 42 weeks.

One sign that something is amiss that mothers can watch for is how much their child moves. Ideally, you should be able to feel ten kicks in a two-hour window. If you are concerned that your child isn’t moving as often as they usually do, tell your doctor.

What Is Intrauterine Fetal Demise?

A stillbirth or an intrauterine fetal demise is the term that medical experts use to describe when a fetus dies later on in a pregnancy. Although there is no agreed upon time, most doctors deem the death to be an IUFD if it occurred after the 20th week of gestation. This is as opposed to a miscarriage, which happens before the 20th week.

While the causes of IUFDs are not always apparent, there are certain known risk factors that doctors can screen for, diagnose and monitor throughout the pregnancy. If the IUFD was caused by insufficient diagnosing, screening and monitoring, then it could be a possible case of medical negligence on the part of the doctor.

What Causes Intrauterine Fetal Demise?

In many cases, it’s difficult to know the exact cause of an IUFD, but doctors should thoroughly screen, test and monitor the mother and the baby to address any potential signs that could indicate the risk of an IUFD.

In cases where doctors can determine the cause of an IUFD, the underlying cause falls into three categories: fetal, maternal or placental pathology.

Fetal Pathology

Fetal pathology means there was something wrong with the fetus and its development, which caused its demise.

Some potential problems with the fetus may include:

  • Multiple fetuses in the womb at one time
  • A genetic or hereditary abnormality
  • Slow growth in the womb
  • Contracting an infection, such as fifth disease or listeria, from the mother while in the womb

Maternal Pathology

Sometimes, an IUFD is caused by an issue with the mother’s health. However, issues with the mother account for the least amount of IUFD incidents.

Some of the causes of IUFD related to the mother include:

  • A pregnancy lasting longer than 42 weeks
  • Her diabetes being poorly controlled
  • Advanced maternal age
  • Experiencing preeclampsia or eclampsia
  • Having a different blood type from her child
  • Rupturing her uterus
  • Weight issues
  • The mother being a smoker

Placental Pathology

Problems with the placenta account for almost 65 percent of IUFD cases when the cause is known.

Possible problems involving the placenta that cause an IUFD include:

  • Umbilical cord accident
  • Abruption (separation of placenta from the uterus wall)
  • Premature rupture of membranes
  • Fetomaternal hemorrhage
  • Placental insufficiency

The listed risk factors are not the direct cause of an IUFD. However, they are issues that lead to IUFDs, which is why it is vital for them to be monitored throughout the pregnancy.

Intrauterine Fetal Demise Symptoms

All pregnant mothers should be aware of the signs and symptoms of IUFD.

Symptoms that may indicate IUFD include:

  • Not feeling the fetus moving or kicking
  • Pain in the abdomen
  • Infection or high fever
  • Bleeding from the vagina

Diagnosing Intrauterine Fetal Demise

Your medical caregiver will be able to determine if there has been an IUFD.

Doctors may use the following tests to diagnose a case of IUFD:

  • Ultrasound: Checking for signs of movement and life within the womb.
  • Non-Stress Testing: The fetus is connected to a fetal heart monitor for 20 minutes to ensure proper heart rate.
  • Biophysical Profile: An ultrasound and a non-stress test together check for vital signs in the fetus.
  • Umbilical Artery Doppler Velocimetry: Checking for proper blood flow in the umbilical cord.

Even though it may be an extremely difficult experience, it is essential for mothers to be involved in the diagnosis process so that they can understand what, if anything, went wrong. It will also help the mother to see for herself through ultrasound that there is no heartbeat.

After an IUFD, doctors do their best to determine the cause. Although it is uncommon for a woman to experience multiple stillbirths in a row, these tests can let her and her medical team know if there is anything they need to watch more closely next time.

Because the cause of the IUFD may be maternal, placental or fetal, doctors test all three aspects. This means the mother will likely undergo a series of tests to determine if there are any underlying conditions that can be treated. The placenta will also be examined, and, with the parents’ consent, the fetus will be autopsied.

While the thought of having their child autopsied can be heart-wrenching for the parents, it can also help doctors determine the cause of the IUFD. That information can then be used to help the doctors and mother prevent the same issue from occurring again.

Decisions After Intrauterine Fetal Demise

Once doctors are confident that an IUFD has occurred and the mother is told, doctors will suggest that the pregnancy is terminated. This doesn’t have to happen right away. Parents can choose to wait for the mother’s labor to be induced until they are emotionally ready for it. Or, if the mother is carrying multiple children, she can wait until the other child is fully developed.

The period following an IUFD is highly emotional. It’s crucial for the parents to have support and counseling to help them through this time. Some parents keep a folder that contains photos, a copy of the child’s footprint or handprint, and a lock of hair so the family can preserve the memory of their baby.

Compensation for Intrauterine Fetal Demise Related to Medical Negligence

Mistakes by doctors can lead to an IUFD. For example, if the doctor failed to control for a risk factor, it may be considered medical negligence. If you believe your doctor did not meet the standard of care or that their treatment, or lack thereof, was negligent, financial compensation may be available to you for your loss.

Contact the Birth Injury Justice Center today at 800-914-1562 to work with an attorney experienced in medical negligence and malpractice. Get a free medical case review to learn more about your next steps.

Author:Birth Injury Justice Center
Birth Injury Justice Center

The Birth Injury Justice Center was founded in 2003 by a team of legal professionals to educate and empower victims and families affected by birth injuries. Our team is devoted to providing you with the best resources and legal information for all types of birth injuries.

Last modified: January 9, 2019

View 3 References
  1. Can You File a Malpractice Lawsuit in a Stillbirth Case?” All Law. Retrieved from: https://www.alllaw.com/articles/nolo/medical-malpractice/lawsuit-stillbirth-case.html. Accessed December 27, 2018.

  2. “Evaluation of Fetal Death” Medscape. Retrieved from: https://emedicine.medscape.com/article/259165-overview#a8. Accessed December 27, 2018.

  3. “Kick Counts” American Pregnancy Association. Retrieved from: http://americanpregnancy.org/while-pregnant/kick-counts/. Accessed December 28, 2018.