DOI: 10.36347/sajb.2014.v02i10.014

Pages: 724-727

Vaginal birth is the recommended mode of delivery for most women with intrauterine fetal demise, but caesarean birth would need to be considered with some. The factors related to the indication of caesarean section in pregnant women with dead fetus are poorly studied. The study of fetal death is crucial in promoting actions for maternal and child health. Aim of the study was to determine the incidence, indications and maternal morbidity and mortality associated with Caesarean section in patients with intrauterine fetal and to establish the place of Caesarean section in present day scenario. A retrospective case review of all patients with IUFD was done. It included pregnant women diagnosed with fetal death, with gestational age 20 weeks onwards. Maternal demographic profile, delivery-IUFD interval, mode of delivery: caesarean section/ vaginal and maternal complications were the main outcome measures. Total deliveries during the audit period were 12699; total number of caesarean section was 3386 (26.6%). Number of intrauterine fetal demise beyond 20 weeks of pregnancy was 162 out of which 21(12.9%) were terminated by caesarean section. The main indications were failed induction of labour, previous 2 LSCS, antepartum haemorrhage, hypertensive disorders of pregnancy and obstructed labour. Protective factors were use of misoprostol and low birth weight of fetus.8 (38%) patients delivered by caesarean section developed major postoperative complications like postpartum haemorrhage, shock, endometritis, and wound infection. In conclusion, although the recommended mode of delivery of IUFD is vaginal, caesarean section becomes indicated in certain cases.