A Case-control Study of Fetal Death In Utero

Lim, Song; Lee, Seo Young

Abstract

The purpose of this study is to examine the cause of intrauterine fetal death by making a comparative analysis of the clinical difference between the pregnant women with such a case and those without it. For full seven years from January 1987 to December 1995, Moonwha Hospital saw 367 cases of intrauterine fetal death. Among them, selected for this study were the cases where at least 20 gestational weeks had passed since last menstrual period and the 127 cases where the measured fetal weight after delivery was 500 gm, and both cases were limited to those with exact records. Controls were the pregnant women who had given birth to normal fetuses during the above period. They were selected through random sampling and student t-test and x2-test were conducted for data analysis using SPSS PC ver 5.01 for Window. The findings are as follows: The prevalence of intrauterine fetal death was 1.09%. Its risk was about 3 times higher for the gravida under 25 and over 35. The frequency of intrauterine fetal death was statistically significant for nullipara(p=0.024). Cases showed noticeably frequent spontaneous abortion and induced abortion(p=0.020, p=0.029 each). Intrauterine fetal death rate was about 5 times higher in case delivery interval was one year or over 6 years. Sex ratio was found the same. Fifty percent of intrauterine fetal deaths happened within 28 weeks, while cases after term were only 5 percent. Unexplained cases topped the list of the causes, followed by congenital anomaly and then pregnancy-induced hypertension. Induced delivery took the greatest share of the whole delivery methods(82.7%), followed by spontaneous delivery(10.2%) and then laparotomy(7.1%). The conclusion is that proper antenatal care should be taken of fetuses on the basis of risk factors of antepartum and intrapartum so that unnecessary intrauterine fetal death can be prevented and furthermore pregnant women`s physical and mental pain can be reduced.