CAUSES OF INTRA UTERINE FOETAL DEATH

Objective: To find out the frequency and causes of intra uterine foetal death and associated congenital anomalies. Material and Methods: This prospective study was conducted at department of Obstetric and Gynecology, Lady Reading Hospital, Peshawar from 1 st  January 1997 to December 1997. In this study death of the foetus in-utero after 28 weeks of pregnancy was taken and death of the foetus during labour was excluded. Results: During the time period the total number of deliveries was 3220 and the total number of patients with intra-uterine foetal death was 302 (9.37%). Among 302 cases there were 296 singleton pregnancies (98.01%), while six (1.98%) were multiple gestation pregnancies with both the foetuses dead. The most common cause of intrauterine foetal death was antepartum hemorrhage (APH) in 72 cases (23.84%) followed by preeclampsia in 29 (9.60%) cases, eclampsia in 16 (6.29%) cases, diabetes in 45 (14.90%) cases, congenital anomaly in 60 (19.86%) cases, infections in 42 (13.90%) cases, cord prolapse in 10 (1.31%) cases, Rh-incompatibility in 8 cases (2.64%), and no cause was found in 20 cases. Most common congenital anomalies were anencephaly (10.26 %) and hydrocephalus (4.30 %). Conclusion: Advanced maternal age and multigravidity was associated with increase risk of intra-uterine foetal death. Higher incidence of APH, Pre-eclampsia, eclampsia, diabetes and congenital anomalies showed lack of antenatal care. Antenatal care is by far the most important step in the prevention of intrauterine foetal death.