Publication:

An observational study of intrauterine death in high-risk pregnancy at a tertiary care hospital

Background Intrauterine death (IUD) is a major obstetric complication and a distressing event for both families and caregivers. Identifying the causes and associated obstetric conditions is important for developing preventive strategies and improving the quality of antenatal care. This study aimed to characterize the clinical and obstetric profile of IUD cases at a tertiary care hospital and to evaluate the associated maternal risk factors.

Methods An observational study was conducted at LLRM, a tertiary care centre. Out of 5000 total deliveries during the study period, 149 cases of intrauterine death were identified and included in the analysis. Maternal demographic details, gestational age, obstetric complications, booking status, residence, mode of delivery and associated clinical conditions were recorded and analyzed.

Results The IUD rate in this study was 29.8 per 1000 deliveries (2.98%). Most cases were in the age group of 21–25 years (51.0%), with a mean maternal age of 25.8 years. Multigravida women made up 64.4% of the cases. A large number of patients were unbooked (79.2%) and from rural areas (71.1%). Preterm labour was the most common associated complication (63.1%), followed by severe pre-eclampsia (27.5%), antepartum eclampsia (17.4%), antepartum haemorrhage (14.1%) and gestational diabetes mellitus (14.1%). Most patients (71.1%) had vaginal delivery, while 28.9% underwent caesarean section. Meconium-stained liquor was seen in 38.3% of cases.

Conclusions Hypertensive disorders of pregnancy and preterm labour were the most common conditions associated with IUD in this setting. The high number of unbooked and rural patients highlights the importance of proper antenatal care. Early registration, regular antenatal check-ups and timely referral to higher centres remain the cornerstone for prevention of IUD.