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1. Intrauterine foetal death or demise is the death of a baby in the uterus before the 20th week of gestation. Pregnancies that are lost before 12 weeks are considered miscarriages.
2. Foetal death before 20 weeks is often challenging for the mother to know. However, after 20 weeks of pregnancy, one of the signs is loss of movement. And this is a red flag that should get one seeking medical attention. Before 20 weeks, only an ultrasound can diagnose foetal death conclusively.
3. It is recommended that a pregnant woman get three ultrasounds done. First ultrasound should be done in the first trimester (12 weeks), second trimester at 12-28 weeks and last in the third trimester 28-36 weeks.
4. The symptoms of intrauterine foetal demise are: stopping of fetal movements and kicks after 20 weeks, spotting, per vaginal bleeding, abdominal pain and lack of foetal heartbeat on ultrasound.
5. Early intrauterine fetal death normally presents with vaginal bleeding and lower abdominal pains. While Elsie had these same symptoms she did not bleed, so she had an incomplete miscarriage.
At this point, the appropriate medical attention is required to sort out the complication.
Late complications may lead to severe maternal infection or disintegrated intravascular coagulation (DIC). This is where blood clots block some blood vessels and this can lead to death.
6. Common causes of foetal death include:
Congenital birth defects Genetic abnormalities Placenta disorder and dysfunctions Umbilical cord complications and uterine rupture7. Factor that could trigger foetal death include:
A mother’s health is considered a risk factor if for instance the mother is suffering from hypertension, blood disorders, diabetes, obesity, lupus and thyroid disorder. Habits such as smoking or drinking alcohol Advanced maternal health: Women older than 35 are more likely to have unexplained stillbirths than younger women Multiple pregnancies and trauma8. Mothers conceiving after age 35 should especially follow up with antenatal care and not skip any ultrasound.
Use of ultrasound during antenatal care (1st trimester, 2nd trimester, 3rd trimester) helps in diagnosing fetus at high risk of demise.
- Source: Dr John Odero Ong’ech, an obstetrician and gynaecologist
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