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Gyne > IUFD > Flashcards

IUFD Flashcards

1
Q

Define IUFD

A

Fetal death after 20 weeks gestation but before onset of labor

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2
Q

What is the MC cause of IUFD

A

Unkown

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3
Q

Give RF for IUFD:

A
  • IUGR
  • hydrops fetalis
  • umbilical cord accident
  • infection
  • hemorrhage
  • DM, APS, thrombophilia, HTN
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4
Q

Fetal cause of IUFD:

A
  • infection
  • hydrops
  • isoimmunisation
  • hemorrhage
  • twin to twin
  • asphyxia
  • IUGR
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5
Q

Umbilical cause of IUFD:

A
  • prolapse
  • loop or knot
  • velamentous insertion
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6
Q

Placental cause of IUFD:

A
  • abruptio, previa, vasa previa
  • infarction
  • insufficency
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7
Q

Amniotic fluid cause of IUFD:

A
  • chorioaminitis

- oligo and polyhydraminos

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8
Q

Uterus cause of IUFD:

A
  • Rupture

- anomalies

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9
Q

How to diagnose IUFD clinically

A

1- Absent fetal movement
2- small for date uterus
3- non-detectable fetal heart

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10
Q

How to confirm IUFD

A

US showing lack of fetal movement or absence of cardiac activity

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11
Q

How to manage IUFD

  • between 14-28w
  • after 28w
A
  • expectancy or IOL

- misoprostol followed by oxytocin

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12
Q

What is the % of patients experiencing spontaneous labor after 2-3 weeks of fetal demise

A

80%

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13
Q

What are the alternatives if patient with IUFD did not go into spontanous labor?

A
  • IOL

- Dilation & evacuation

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14
Q

What are the indications of IOL in patients w\IUFD

A

Emotional burden, chorioaminitis, DIC (retained dead fetus)

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15
Q

What to give to induce labor in IUFD

A
  • Vaginal suppository of PG E2 (dinoprostone) = 12th to 28th weeks
  • misoprostol PG E1
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16
Q

What should physician do when they are in the period of watchful expectancy?

A

monitoring of Fibrinogen, Hct, platelet

17
Q

What does decrease in fibrinogen levels indicate in IUFD

A

Consumptive coagulopathy

18
Q

How to clarify diagnosis of consumptive coagulopathy

A

1- high PT and ApTT
2- fibinogen-fibrin degredation products
3- decreased platelt

19
Q

How to follow up patients with IUFD

A
  • TORCH, parvovirus, listeria culute
  • anticardiolipin
  • family hx of thrombophilia
  • fetal chromosomal and autopsy
  • kleihaur betke test (fetomaternal hemorrhage)

Gyne (18 decks)

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