Intrauterine Fetal Demise

The reason for intrauterine fetal demise is unclear in 25% to 60% of cases. Usually, fetal demise is given different names depending on the gestational growth weeks the fetus was at. Miscarriage is the term often used when a fetus has died before 20 weeks of gestation. Beyond 20 weeks of gestation, stillbirth is often the term used. Regardless of the term used, It is typically emotionally harrowing for the expectant parents. Determination that the fetus has died is done through auscultation of heart sounds and ultrasound. These methods show visually and audibly that the heart is no longer beating. Sometimes the woman’s body will expel the fetus on its own, or the process can be induced with drugs. 

Three categories are given of different reasons a fetus dies during gestation. These categories are fetal pathology, maternal pathology, and placental pathology. Some fetal demise explanations under fetal pathology are genetic and congenital abnormalities. More than one fetus in the uterus at the same time can lead to space and nutrient deficiencies that cause one or both fetuses to fail developmentally -- intrauterine growth restriction is the term used for this, regardless of whether it is one or more fetuses. Hydrops, or excessive fluid accumulation in places it isn’t supposed to be, is yet another reason for fetal demise. Lastly, infection, which covers many possibilities, is another explanation.

The placenta is an organ that forms within the uterus to facilitate the exchange of oxygen, nutrients, and waste products between the mother and the developing baby. A new placenta forms for every pregnancy and it is expelled shortly after delivery of the baby. A placenta that forms abnormally can lead to fetal demise. Abruption is the term used when the placenta separates from the uterus before the birth of the baby. Vasa previa is a rare condition where the blood vessels belonging to the baby are arranged externally in a way that they will easily rupture during delivery. This condition is not typically apparent before delivery and the baby is usually stillborn

due to massive blood loss. Premature rupturing of membranes is when labor is initiated too soon. Infection, low maternal weight, and other risk factors can lead to the body trying to deliver the fetus before it has finished its gestational time. Delivery of the baby before it is developmentally ready can have serious consequences for the baby’s health. It can also be detrimental to mother and child as hemorrhage in one or both is a possibility. Immediate medical intervention and diagnosis/treatment are the best ways to prevent loss of life for both mother and baby. Lastly, cord accidents are another reason why fetal demise can happen. the umbilical cord is the lifeline between the baby and mother. It delivers all of the baby’s nutrient and oxygen needs. Compression of the umbilical cord can lead to a lack of oxygen to the fetus and result in death. 

Maternal pathology that can lead to fetal demise is a lengthy list. A pregnant woman with prior health conditions might have trouble carrying a baby to term as her health is compromised. some of these health complications that can cause fetal demise are:

  • Obesity
  • Smoker
  • Diabetic
  • Lupus
  • Infection
  • Maternal trauma or death
  • Inherited thrombophilia
  • Hypertension (high blood pressure)
  • Antiphospholipid syndrome
  • Hemoglobinopathy

Along with high blood pressure as a preexisting condition, hypertension that develops during pregnancy can also be lethal to the fetus. Preeclampsia and eclampsia are the terms given to this state. The age of the mother can also affect the fetus. This is important because the eggs the woman carries are as old as she is. the older the eggs become, the more potential DNA damage they can sustain over a woman’s lifetime. Rh disease can be a problem if the mother is Rh negative, while the baby she is carrying is Rh positive. If the mother's blood comes into contact with fetal blood, it will identify it as foreign, and the mother’s immune system with produce antibodies that can attach to the red blood cells of the baby’s blood and kill them. Rh disease is very treatable, however, and is identifiable early with proper prenatal care. Post-term pregnancies, or gestation going beyond 42 weeks lead to higher incidences of stillbirth. the larger the baby gets, the less room they have in the uterus, and the more likely cord accidents and placental demise are to occur. Lastly, uterine rupture can lead to fetal and/or maternal death.

If you believe you lost a baby due to insufficient prenatal diagnostic tests or a failure to diagnose a disease that led to miscarriage or stillbirth, then you may have a medical malpractice case. Call the Sweeney Law Firm and let us review the facts. If we take your case, there is no cost for representation unless there is a settlement or recovery of funds made on your behalf.