A retrospective study to evaluate etiological factors associated with intrauterine fetal death at tertiary referral centre

Background: Amongst various community health indicators available for measurement of quality and impact of health services in developing countries, perinatal mortality finds its position as being one of the top most single indicators even today. In order to have a decrease of the fetal mortality rate, it is necessary to know the etiology of fetal death and its associated risk factors in different populations. Thus the purpose of this study was to investigate about the prevalence, patient profile, socio-demographical and etiological risk factors associated with fetal losses beyond 24 weeks of pregnancy in our hospital.Methods: This study was conducted at Chirayu Medical College & Hospital, Bhopal, India. Retrospective data of all the cases with ≥24 weeks gestation with intrauterine fetal death, admitted in the study period (November 2010- December 2015) were collected (n=51). All socio-demographic, antenatal and intrapartum risk factors associated with IUFD were recorded in proforma and statistical analysis done.Results: Total numbers of births in the study period were 1410, out of which fetal losses beyond 24 weeks of gestation occurred in 51 cases. This gave the perinatal mortality rate for our hospital as 36.17/1000 live births. This rate is much more than the national figure quoted by the central government in 2012 as 28/1000 live birth. Hypertensive disorders of pregnancy were the most commonly responsible factor (27.45%) in the study group followed by congenital malformations (9.80%). In 11.76% cases cause was not explained.Conclusions: It is a well-established fact that adequate antenatal care is associated with better pregnancy outcome, but universal antenatal care is not the protocol in our area, reasons being ignorance, illiteracy, lack of awareness of importance of antenatal care, poverty and non-availability of health care facilities/skilled personnel/infrastructure/transport. Health education and emphasis on the need of each and every delivery being institutional under supervision of appropriate personnel needs to be propagated in the community aggressively. This only will help in reducing a number of preventable fetal deaths and huge loss of our national asset