Fetal Death - Causes and Symptoms

Definition

Endouterial fetal death means the loss of the fetus that occurs after the 22nd week of gestation. This event recognizes maternal, placental and fetal causes. Some of these overlap in part with those already reported for spontaneous abortion. Overall, the most frequent causes are the untimely detachment of placenta (or abruptio placentae) and all those situations in which there is no oxygen supply to the fetus (asphyxia). Other placental complications responsible for fetal death include corioamnionitis (severe inflammation of the amniotic cavity and surrounding membranes), utero-placental vascular insufficiency, cervical incontinence and umbilical cord problems (eg prolapse, thrombosis, knot or twist). The death of the fetus can also derive from conditions affecting the mother, such as infections, pre-eclampsia or eclampsia, sepsis, substance abuse (eg cocaine, alcohol, etc.) or severe trauma. Exposed to the risk of fetal death, various diseases that the mother can suffer from, such as uncompensated diabetes mellitus, thrombophilia (a situation in which blood coagulates in excess), pre-pregnancy or hypertension, nephropathy and disease with immunological pathogenesis. As far as the fetus is concerned, however, serious congenital malformations (eg cardiac or cerebral), chromosomal abnormalities, genetic syndromes and haemolytic disease (maternal-fetal isoimmunization, with severe fetal anemia) can induce this event. Sometimes the causes of intrauterine death of the fetus remain unknown.