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Znar A. Tamar
Ali Ahmad Ali
Faris Ismail Ali
15/Dec/2013
Objective
Introduction
Definition of intrauterine death
Epidemiology of IUFD
Etiology or causes of IUFD
Risk factors and clinical features
Diagnosis of IUFD
Treatment & management
Nursing care of IUFD
Reference
introduction
Definition of IUFD
Epidemiology
In the present investigation the epidemiological
factors responsible for intrauterine fetal deaths after
20 week of gestation were studied. A
retrospective study of 16882 pregnancies registered
and managed in the Department of Obstetrics and
Gynecology, in united state
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Etiology
Pregnancy complications:
- Pre-eclamptic toxemia
- Antepartum haemorrhage : placenta previa,
abruptio placentae
Chronic hypertension
Chronic nephritis
Diabetes
Severe anemia
Hyperpyrexia
Hyperpyrexia
Syphilis, Hepatitis, toxoplasmosis etc.
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Fetal
- Congenital malformation
- Rh-incompatibility
- Post maturity
External version
Idiopathic 20 30%
Maternal Complications
Decreased platelets
Decreased fibrinogen
Increased PT/PTT (Clotting times)
Clinical bleeding / oozing from all sites
RX involves DELIVERY, pRBCs, FFP, PLATELETS,
Supportive Management
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Risk factors
Multiple pregnancy
Advanced maternal age
History of fetal demise (IUFD)
Maternal infertility
Maternal haemoconcentration
Maternal colonization with certain
pathogens
Small for gestational age infant
Obesity
Paternal age
African American race
Clinical features
Absence of fetal movement
Vaginal bleeding
abdominal pain
Diagnosis of IUFD
In most patients, the only symptom is decreased fetal
movement. An inability to obtain fetal heart tones
upon examination suggests fetal demise; however, this
is not diagnostic and death must be confirmed by
diagnostic tests .
Labor should be induced as soon as possible after
diagnosis. Patient responses vary in regard to this
recommendation; some wish to begin induction
immediately, while others wish to delay induction for a
period of hours or days until they are emotionally
prepared.
Diagnostic tests
Ultrasound: Caregivers can see if there is a heartbeat and
movement of the fetus.
ultrasound to check the blood flow inside the umbilical artery. This
artery carries blood from the fetus to the placenta.
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Extra-amniotic Foley catheter induction of labor:
A catheter is inserted into the cervix. Medicine
goes through the catheter. The medicine prepares
the cervix for labor, or starts contractions. The
fetus is delivered through the vagina.
Dilation and evacuation (D and E): The cervix is
dilated, or made larger. The fetus is then removed
through the vagina
Dilation and curettage (D and C): The cervix is
dilated, and caregivers use tools to remove the
fetus through the vagina.
Pain management
References
www.drugs.com
www.allnursing.com
www.medical.com
www.slideshare.com
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