To Identify Common Risk Factors Associated with IUFD in Rangpur Medical College Hospital, Rangpur, Bangladesh

Abstract

Introduction: Intra uterine fetal death is always an unacceptable event not only by the expecting mother and family but also by the obstetrician. Both the woman & the obstetrician become desperate to know the cause of IUFD & its prevention in future pregnancy. In more than 50% cases causes of fetal death cannot be determined. Objective: To identify common risk factors associated with IUFD. Methods: It was a cross sectional study was conducted in the department of Obstetrics & Gynaecology, Rangpur Medical College Hospital, Rangpur over the period of 6 months dated from July 2017 to December 2017. Sample size: 50 cases. All pregnant woman after 28 weeks of gestational age who were admitted in antenatal ward of the Gynae & Obstetric department of Rangpur Medical College Hospital, Rangpur. During the study period all the patients with IUFD & Fetuses who does not show any signs of births were the study population of this study. Result: Total 50 patients included in your study. Table-I shows that most of the women with IUFD cases fall in the age group of 20-30years 76% and 72% of women had primary level of education. Most of the patient 70%were from middle class. All were housewife. Majority (88%) were from rural area. Majority 52% were primigravida, 50% were>36weeks of gestational age, history of abortion were in 14% cases & IUFD in 04% cases. None of the patient took regular antenatal care, most of the Patient (72%) took irregular ANC, and 28% of patient did not take any ANC. Hypertensive disorder was the major risk factors 34% which include chr. HTN. 08%, preeclampsia 10% & eclampsia 16%, Other risk factors were PROM 16%, Prolong labor and obstructed labour 12%, GDM 06%, Rupture uterus with previous C/S 10%, Placental factor 08%, Cord prolapse 06%, Severe IUGR 04%, no risk factors found in 04% cases. 72% of the cases had mild anaemia, 60% were normotensive & 40% had high blood pressure, Scar tenderness were found in 20% cases who had H/O C/S. the patient 58% had Hb% 08-10gm/dl, all were Rh+ve mother, PPBS raised in 06% cases. In USG liquor volume normal 20%, mild to moderate oligohydramnios in 44%, moderate to severe oligohydramnios in 20% & severe oligohydramnios in 16% cases. Shows vaginal delivery had occurred in 86% cases. 14% need operative intervention among which 10% laparotomy were due to rupture uterus & 04% LSCS were due to scar tenderness. Maternal outcome in 84% cases were uneventful. Wound infection occured in 12% cases & Puerperial sepsis occurred in 04% cases. Conclusions: PIH, PROM were leading causes of IUFD. Majority of women who had IUFD were emergency admission who had not received adequate antenatal care. A significant proportion of IUFD is preventable by health education to patients and community for regular antenatal care, about warning signs during antenatal period, hospital delivery and early referral.