Fetal Demise

Question 1

What are risk factors for fetal demise in the second trimester?

Answer 1

AA race 
AMA 
ART 
DM 
cHTN 
Smoking 
Alcohol use 
Multiple gestation
Male fetus 
Unmarried status
Nulliparity

Question 2

What are risk factors for fetal demise in the third trimester?

Answer 2

DM
cHTN
Post term pregnancies

Question 3

What is your differential diagnosis for a second trimester fetus demise?

Answer 3

APS
Obesity
Substance
Chromosome/genetic abnormalities

Question 4

What is your differential diagnosis for a third trimester fetal demise?

Answer 4

Late term pregnancies
Growth restriction
Abruption

Question 5

What workup do you perform following a first trimester fetal demise?

Answer 5

-CVS

Question 6

What workup do you perform following a second/ third trimester fetal demise?

Answer 6

TSH 
HbA1c 
APS
Parvovirus
KB
Coagulation 
Amniocentesis 
1x1 placental block 
Umbilical cord segment
Fetal autopsy

Question 7

Following a fetal demise in the second or third trimester, which evaluations offer the greatest yield?

Answer 7

Amniocentesis for CMA

Question 8

How would you counsel a patient regarding route delivery following a second/third trimester fetal demise and a prior cesarean section?

Answer 8

No fetal benefit for hysterotomy, would encourage cytotec in second trimester and oxytocin in third trimester