ABSTRACT

Aim: To analyze the maternal and obstetrical risk factors associated with intrauterine fetal demise and to outline the prevention strategies.

Study design: cross sectional study

Place and duration of study: A period of one year from 1^st June 2016 to 31^st May 2017 in the Department of Obstetrics and Gynecology, Avicenna Medical college, Lahore.

Methodology: All the patients with intrauterine fetal demise were selected from the total number of patients presenting to the department of obstetrics and gynecology through Outpatient department or emergency room. Written informed consent was taken from the patients for the use of personal data for study purpose. The demographic variables, maternal and obstetric risk factors were calculated. The fetal condition at birth was assessed by baby weight, congenital abnormalities, placental weight, number of vessels in cord, placental abnormalities like calcification/ abruption, intrauterine death fresh or old and examination for morphological abnormalities. After reviewing the results, prevention strategies were outlined.

Results: A total of 52 patients with intra uterine fetal demise were reported among 1070 deliveries conducted during the study period. The incidence rate of stillbirth was 48.59/1000 live births. 85% of the patients were un booked. The other observations were 46% were anemic, 42% were hypertensive with 3.8% had eclampsia.

Conclusion: The incidence of stillbirth in our population is higher than that reported from developed countries. This is associated with anemia, hypertension, placental abruption, illiteracy, macrosomia, diabetes, high BMI, polyhydramnios and ruptured membranes. Lack of antenatal care and low socioeconomic status are the other reasons for high stillbirth rate in urban rural belt of Lahore.

Key words: anemia, antenatal care, hypertension, intrauterine fetal demise, stillbirth.