Intrauterine fetal death can occur at any stage of pregnancy. Recurrent pregnancy loss during the first trimester requires a more in-depth assessment including genetic evaluation and counseling. Diagnostic ultrasound to determine the precise gestational age of fetal loss is indicated. Examination of the dead fetus and placenta are of extreme clinical significance following a recurrent pregnancy loss.
The intrauterine fetal demise of an infant (stillbirth) during the second and third trimester of gestation mandates an evaluation to see if the cause of fetal death was diagnosable and preventable. Potential causes of intrauterine fetal death include:
Second and third trimester:
umbilical cord accident
obstetrical disorders (preeclampsia)
fetal growth restriction (IUGR)
Although some of these conditions are beyond any medical treatment, most of them are susceptible to being diagnosed in anticipation of the delivery of the infant. Proper diagnosis and timely intervention in cases of fetal distress, fetal anemia, preeclampsia, fetal growth restriction (IUGR) and placenta abruptio require prompt delivery of a live infant with postnatal return to health.
While labor is a stressful event under most circumstances, infants tend to tolerate the process of labor and delivery without any untoward long term injury. Intrauterine fetal death during labor is rarely a sudden event. Proper monitoring of the infant and the mother will usually show signs of fetal intolerance to the uterine environment well in advance of the infant's demise. Indications of a hostile intrauterine environment include:
decreased fetal movement
reduced amniotic fluid volume
small for gestational age
severe abdominal pain
Prenatal evaluation by means of ultrasound, fetal monitoring and tolerance of labor assessment will usually give an indication of a hostile intrauterine environment which requires immediate delivery of the infant by means of cesarean section. Failure to timely deliver an infant that shows signs of intrauterine intolerance resulting in a stillbirth is generally the result of medical negligence on the part of the treating medical provider. If your child's condition was the result of medical negligence, Dr. Borten and the medical malpractice attorneys at Gorovitz & Borten can help you assert your rights and get the compensation you deserve.
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