Fetal death refers to the intrauterine demise of a fetus before delivery, with the threshold separating it from early pregnancy loss defined by gestational age according to the classification in use. It encompasses both early intrauterine loss and stillbirth at later gestations, and is identified by the absence of f…
Fetal death refers to the intrauterine demise of a fetus before delivery, with the threshold separating it from early pregnancy loss defined by gestational age according to the classification in use. It encompasses both early intrauterine loss and stillbirth at later gestations, and is identified by the absence of fetal cardiac activity and movement. The causes are multifactorial and often overlap, including placental dysfunction and abnormal placentation, congenital and chromosomal anomalies, infection, and maternal conditions such as hypertensive disorders, diabetes, and hemoglobinopathies. Maternal anemia and disorders of hemoglobin, including sickle cell disease, can compromise fetal oxygen delivery and are recognized contributors to adverse fetal outcome, while structural problems such as placenta previa or abnormal cord and uterine anatomy raise the risk of demise. Evaluation aims to establish a cause through maternal history, fetal and placental examination, imaging, and laboratory and genetic studies, since identifying a mechanism informs care in future pregnancies. Prenatal surveillance, management of maternal disease, and timely obstetric intervention are central to prevention. Beyond its clinical dimensions, fetal death carries profound psychological consequences for families, and accurate ascertainment, classification, and counseling are essential components of obstetric and perinatal practice.
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