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Case 29 - A 40-Year-Old Presents at 34 Weeks’ Gestation with Absent Fetal Movement

from Section 3 - Antepartum (Late Pregnancy)

Published online by Cambridge University Press:  08 April 2025

By
Taylor Gilmore
Edited by
Peter F. Schnatz ,
D. Yvette LaCoursiere ,
Christopher M. Morosky ,
Jonathan Schaffir ,
Vanessa Torbenson  and
David Chelmow
Peter F. Schnatz
Affiliation:
The Reading Hospital, Pennsylvania
D. Yvette LaCoursiere
Affiliation:
University of California, San Diego
Christopher M. Morosky
Affiliation:
University of Connecticut School of Medicine
Jonathan Schaffir
Affiliation:
The Ohio State University College of Medicine
Vanessa Torbenson
Affiliation:
Mayo Clinic Alix School of Medicine
David Chelmow
Affiliation:
Virginia Commonwealth School of Medicine
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Summary

The rate of IUFD is 5.74 per 1,000 live births and decreases to 2.78 per 1,000 live births after 28 weeks. All of these patients should be offered fetal autopsy, genetic evaluation, and examination of the placenta, umbilical cord, and membranes. Other testing is individualized by case. The SMFM and ACOG have proposed an algorithm to assist clinicians: www.smfm.org/publications/322-acog-smfm-occ-10-management-of-stillbirth. Dilation and evacuation and induction of labor are delivery options prior to 28 weeks and depend on patient preference and history. After 28 weeks, general obstetrical protocols for induction of labor are recommended. Antepartum surveillance is recommended starting at 32 weeks and is individualized in patients with a history of IUFD prior to 32 weeks. Consideration can be made to fetal growth scan. Delivery timing is determined by a discussion of the fetal and maternal risks of delivery at or before 39 weeks

Keywords

intrauterine fetal demiseautopsyplacental pathologyinductiondilation and evacuation
Type
Chapter
Information
Pregnancy Complications
A Case-Based Approach
 , pp. 89 - 91
Publisher: Cambridge University Press
Print publication year: 2025

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References

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