What Is Intrauterine Fetal Demise?

Doctors May Use This Term to Refer to a Stillbirth

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Intrauterine fetal demise is the clinical term for stillbirth, the death of a baby in the uterus during pregnancy. The term is usually used for pregnancy losses that happen at or after the 20th week of gestation.

Definition of Intrauterine Fetal Demise

In a medical setting, the term "intrauterine fetal demise" may be used interchangeably with "fetal demise" or "fetal death." These terms all refer to what we know as stillbirth.

Fetal demise is defined differently around the world, based on the gestational age and weight of the fetus when it died. In different places, the threshold can range from at least 16 weeks to at least 26 weeks of gestation and from at least 400 grams to at least 500 grams. Pregnancies that are lost earlier are considered miscarriages, not stillbirths.

In the U.S., death in the womb at or after 20 weeks gestation is generally classified as intrauterine fetal demise and considered stillborn. This article will therefore focus on stillbirths.

Some agencies classify all spontaneous pregnancy losses a fetal death, but the distinction between miscarriage and stillbirth is important for many parents for various reasons. Parents of a stillborn baby will receive a birth and death certificate, while those of a miscarried fetus will not, for example.

Stillbirth Incidence - How Common Is It?

According to the most recent data from Centers for Disease Control and Prevention, fetal death occurred in 6.05 out of 1,000 total births in the U.S. in 2012.

Early stillbirth (20 - 27 weeks) is slightly more common than late stillbirth (28 weeks or later). The 2012 early stillbirth rate was 3.11 out of 1,000 births while the late stillbirth rate was 2.96 out of 1,000 births. 

Stillbirth Causes

Unfortunately, at least 25 percent of stillbirths are unexplained.

This can be very difficult to hear from your doctor.

In the rest of the cases, however, there's at least a good idea of what caused the pregnancy loss.

Here are some of the most common causes of intrauterine fetal death:

Your Risk Factors

There are several factors that put a woman at greater risk for having a pregnancy with stillbirth. It's important to remember, though, that even if you have all of these risk factors, you will probably not have a stillborn baby. 

Your health and lifestyle. Hypertension and diabetes are two of the most important maternal diseases that contribute to stillbirth. Whether or not you smoke or use drugs are also important factors. Conditions such as lupus, renal disease, thyroid disorders, thrombophilia and obesity also increase the risk of stillbirth.

 

Your race. Black women are twice as likely to have a stillborn baby than white women. There are many reasons for this, including social and economic factors and genetics. 

Advanced maternal age. Thanks to prenatal screening, maternal age isn't as much of a factor in stillbirths related to known fetal abnormalities as it used to be. However, women older than 35 are more likely to have unexplained stillbirths than younger women. 

Carrying multiples. Women who are carrying more than one baby are more likely to have a stillbirth. If you're having in vitro fertilization, transferring just one embryo per cycle will reduce your chances of a stillbirth.

Domestic violence. Fetal death is one adverse pregnancy outcome linked to intimate partner violence.

A history of certain pregnancy problems. Having had a prior pregnancy with growth restriction, preterm delivery or stillbirth means you have a higher chance of stillbirth in a subsequent pregnancy. Women who have had a stillbirth are two to 10 times more likely to experience another. Still, the risk of recurrence is small. Most women who have a stillborn baby go on to have a healthy baby down the line.

How Stillbirths Are Treated, and What Happens Next

The most common sign of a stillbirth is the mother no longer feels the baby moving. If your doctor determines that your baby is stillborn, you will probably have two options:

  • Inducing labor with medication so it begins within a few days.
  • Waiting until labor occurs naturally, which usually happens by itself in a week or two. 

After, your doctor will run tests to try to find out why your baby was stillborn.

If you have experienced or are experiencing a stillbirth, it's natural to feel many different types of emotions. Grief is very common. In addition to your own social support group, including your friends and family, you may choose to seek professional help from a counselor or help from a support group of other mothers or couples who have had the same experience.

Also Known As: Stillbirth, Intrauterine Demise, Fetal Demise, Fetal Death

Sources:

Fetal demise and stillbirth: Maternal care. UpToDate. January 29, 2016.

Trends in Fetal and Perinatal Mortality in the United States, 2006–2012. Centers for Disease Control and Prevention. November 2014.

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