What Is Intrauterine Fetal Demise?
Intrauterine fetal demise occurs when a baby dies in utero (in the mother’s womb) after the second trimester (after 20 weeks of gestation). It’s not the same thing as a miscarriage, which is a death in the womb before 20 weeks.
Intrauterine fetal death occurs in 5.74 of every 1,000 live births, according to a 2020 National Vital Statistics report.
While the causes of IUFD are not always apparent, there are risk factors that doctors can screen for, diagnose, and monitor throughout the pregnancy. If a doctor doesn’t recognize pregnancy complications that can result in IUFD, they may be responsible for the loss of your baby.
Have you experienced IUFD and believe it was caused by medical negligence? Talk to one of our caring nurse advocates to learn more about your next steps.
Causes of Intrauterine Fetal Demise
In many cases, it’s difficult to know the exact cause of intrauterine fetal death. Doctors should thoroughly screen, test, and monitor the mother and the baby to address any potential issues that could lead to IUFD.
Possible causes of stillbirth may include:
- Genetic abnormalities
- Inability of the fetus to properly develop due to problems with the placenta
- Ruptured uterus, which can lead to severe bleeding and suffocation
- Umbilical cord complications
Intrauterine fetal death cannot always be prevented. However, there are certain factors that may increase the chances of it occurring.
Intrauterine Fetal Demise Risk Factors
When doctors are able to determine the cause of intrauterine fetal death, it usually falls into one of three categories: placental, fetal, or maternal.
Placental Risk Factors
Problems with the placenta account for almost 65% of IUFD cases when the cause of death is known.
Complications with the placenta that may cause an IUFD include:
- Fetomaternal hemorrhage (placenta transfers blood from the fetus to the mother)
- Placental abruption (separation of placenta from the uterus wall)
- Placental insufficiency (not enough oxygen and nutrients getting to the fetus)
- Premature rupture of membranes (when the amniotic sac surrounding the fetus bursts open; also called PROM)
- Umbilical cord accident (compression, twisting, knotting, etc.)
These risk factors are not the direct cause of intrauterine death. However, they are all complications that can lead to IUFDs, which is why it is vital for them to be monitored by a doctor throughout the mother’s pregnancy.
Fetal Risk Factors
Issues with the fetus and its development can also cause IUFD.
Some potential fetal issues may include:
- Contracting an infection, such as fifth disease or listeria, from the mother while in the womb
- Hereditary or genetic abnormalities
- Multiple fetuses in the womb at one time
- Slow growth in the womb (also called fetal growth restriction, or FGR)
While problems with the fetus are a common reason for stillbirth, they are not the only cause. Maternal risk factors may also play a role.
Maternal Risk Factors
Sometimes, IUFD is caused by an issue with the mother’s health. However, maternal risk factors account for the fewest intrauterine fetal deaths.
Maternal risk factors for IUFD include:
- Advanced maternal age (35 years or older)
- Diabetes that is poorly controlled
- Different blood type than the child
- Hypertension (high blood pressure)
- Preeclampsia or eclampsia (can cause high blood pressure, protein in the urine, and seizures)
- Pregnancy lasting longer than 42 weeks
- Ruptured uterus
- Use of alcohol, drugs, or tobacco during pregnancy
Unfortunately, intrauterine fetal demise rates for non-Hispanic Black women are almost double than those of non-Hispanic White women.
Women with high-risk medical conditions should be monitored carefully by their doctors to reduce the chance of stillbirth. A doctor could be at fault if they don’t monitor a high-risk pregnancy and IUFD occurs as a result.
Signs and Symptoms of IUFD
Intrauterine fetal demise can happen to anyone. Thus, all pregnant women should be aware of some common symptoms. One thing expectant mothers can watch for is how much their child moves.
Ideally, you should be able to feel 10 kicks in a two-hour window. If you’re concerned that your child isn’t moving as often as they usually do, call your doctor right away.
Other symptoms that may indicate IUFD include:
- Infection or high fever
- No fetal movement or heartbeat seen on ultrasound
- Pain in the abdomen
- Vaginal bleeding or spotting
Since the symptoms of stillbirth can be similar to other medical conditions, you should always ask your doctor for a diagnosis.
Were you diagnosed with IUFD? The Birth Injury Justice Center can listen to your story, answer your questions, and get you the support you need right now. Call us today at (855) 218-2723.
Diagnosis of Intrauterine Fetal Demise
An obstetrics (pregnancy) specialist can diagnose intrauterine fetal death by evaluating your symptoms and running tests to see if there are signs of life in the womb.
Doctors may use the following methods to confirm IUFD:
- Biophysical Profile: An ultrasound and a non-stress test are performed to check for vital signs in the fetus.
- Doppler Velocimetry: Sound waves are used to determine if there is blood moving through the fetus, uterus, and placenta.
- Non-Stress Test: An electronic fetal monitor is used to check for a heartbeat while the mother is lying down.
- Ultrasound: Images of the uterus are used to check for signs of movement and life.
Even though it may be an extremely difficult experience, doctors encourage mothers to be involved in the IUFD diagnosis process so they can understand what (if anything) went wrong. Seeing that the baby has no heartbeat may help the mother emotionally process the loss of her child.
Because the cause of the IUFD may be placental, fetal, or maternal, the doctor will normally review all three aspects of the pregnancy. This means the mother will likely undergo a series of tests to determine if she has any underlying conditions that need treatment.
The placenta will also be examined and, with the parents’ consent, the fetus will be autopsied to pinpoint the cause of death.
The information gathered from these postmortem tests might prevent the mother from experiencing another IUFD in the future.
Intrauterine Fetal Demise Treatment Options
Once an IUFD is confirmed, the doctor will present options for terminating the pregnancy and inducing labor.
This doesn’t have to happen right away. Parents can take time to grieve the loss of their baby before inducing labor. If the mother is carrying multiple children, she can wait until they are fully developed and can be delivered safely.
When the mother is ready, common treatment options include:
- Having a catheter inserted with medicine to start contractions
- Dilating the cervix to remove the fetus through the birth canal
- Using medicine to start labor and deliver the fetus naturally
- Performing a Cesarean section (C-section) to remove the baby
The decision of how to deliver a stillborn fetus is a very personal one, and the mother will be able to choose which option she prefers. The obstetrician will discuss the potential side effects of each method, which may include cramps, heavy bleeding, and damage to the uterus.
However, it is critical to seek treatment for IUFD. Keeping a stillborn fetus inside the uterus for too long can cause severe blood loss and infection.
Some stillbirths could have been prevented with proper medical care. Contact us now to learn if you qualify for financial assistance to help you heal both emotionally and physically.
Coping After Stillbirth
The period after a stillbirth is highly emotional, with many parents experiencing overwhelming feelings of sadness, guilt, anger, and helplessness. It’s crucial for parents to have a support system to help them through this time.
If you’ve lost a child to IUFD, you may find comfort talking about the experience with a counselor, family members and friends, and support groups. Finding ways to remember your baby after a pregnancy loss may also help with the grieving process.
Parents can preserve their child’s memory by:
- Donating to a charity in their name
- Holding a memorial or funeral service
- Keeping ultrasound photos
- Saving a copy of their handprint or footprint
Compensation for Stillbirth Due to Medical Negligence
Mistakes by doctors can potentially lead to a birth injury that causes intrauterine fetal demise. For example, if the doctor failed to identify or address an IUFD risk factor, it may be considered medical negligence.
If you believe your doctor did not meet the standard of health care — or that their treatment, or lack thereof, was negligent — financial compensation may be available to you.
The Birth Injury Justice Center partners with birth injury attorneys who are experienced in medical negligence and malpractice. These attorneys can help you pursue justice and financial aid if you qualify.
Get a free case review now to learn more about your next steps.
Intrauterine Fetal Demise FAQs
How common is fetal demise?
Sadly, intrauterine fetal demise affects about 24,000 babies every year, according to the CDC. That is more than 10 times as many deaths as those that occur from sudden infant death syndrome (SIDS).
What is the earliest sign of intrauterine fetal death?
In most cases, one of the first signs of intrauterine fetal death is when a mother no longer feels her baby moving. Women who are past 28 weeks of pregnancy should track fetal kick counts at least once a day.
If you do not feel your baby moving or kicking, you should call your doctor right away or go to the nearest emergency room.
Is there a difference between intrauterine death and stillbirth?
No. Both intrauterine death and stillbirth are terms used to describe the death of a baby during the third trimester of pregnancy, which starts after 20 weeks.
How do you manage intrauterine fetal death?
If intrauterine fetal death happens before labor begins, there are generally three options for removing the baby:
- Cesarean section
- Inducing labor with medicine
- Natural birth
Doctors usually recommend induced labor as the safest option after a stillbirth.