Intrauterine fetal demise (IUFD), also known as stillbirth, refers to the death of a fetus in the uterus after 20 weeks of gestation. It's a devastating event for expecting parents and can occur for various reasons.
Technically speaking, intrauterine fetal demise is distinct from miscarriages. Whereas IUDF occurs after the first 3 months of pregnancy, miscarriages arise within the first trimester of pregnancy (less than 20 weeks of gestation).
Doctors have a fundamental responsibility to provide competent care to pregnant mothers. This includes taking appropriate measures to prevent, detect, and manage conditions that could lead to IUFD. They should monitor fetal health, address maternal risk factors, and promptly intervene when complications arise. Failing to do so could potentially warrant a medical malpractice claim against them.
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Understanding Intrauterine Fetal Demise
IUFD can occur at any point from the 2nd trimester up until the actual labor and delivery. It can be further subcategorized into antepartum (where fetal death occurs before labor begins) and intrapartum (where fetal death happens during labor and delivery).
For parents, diligence and close communication with doctors is crucial. At the same time, doctors must exercise their expertise to the fullest – counseling parents properly so that they may better take care of their baby. Without proper assessment and care for maternal health, various complications may abruptly terminate a pregnancy.
Antepartum stillbirths are categorized further into the following:
- Early stillbirth: 20-27 weeks of gestation
- Late stillbirth: 28-36 weeks of gestation
- Term stillbirth: 37 or more weeks of gestation
Arguably the most tragic among these subcategories, intrapartum stillbirths can occur due to natural complications and medical errors. Healthcare providers must abide by set delivery protocols to ensure the safety of both mother and child. Mismanagement of high-risk pregnancies, ignoring patient concerns, or poor communication within the medical team can lead to devastating consequences.
Intrapartum stillbirths may arise due to:
- Inadequate fetal monitoring
- Failure to recognize signs of maternal and fetal distress
- Delayed cesarean sections
- Improper use of labor-inducing drugs
- Improper use of delivery tools (i.e., clamps, vacuums, etc.)
What Causes Intrauterine Fetal Demise?
A doctor's failure to address crucial risk factors may allow complications to develop – increasing the chance of stillbirths. Let’s study these factors further.
Risk Factors
Awareness of these risk factors can help in the early identification and management of high-risk pregnancies, potentially reducing the incidence of IUFD. Some of the more common risk factors for intrauterine fetal demise include:
- Advanced maternal age (for mothers over 35)
- Smoking, alcohol, or drug use
- Diabetes
- Obesity
- Epilepsy
- Chronic hypertension
- Chronic respiratory diseases
- Chronic liver disease
- Thyroid disorders
- Autoimmune diseases
- Cardiovascular diseases
- Thrombophilias
- Sickle cell disease
Proper management of these conditions before and during pregnancy, along with close monitoring, can help reduce the risk. Women with these conditions need to receive preconception counseling and specialized prenatal care.
Complications that Cause Stillbirth
As said earlier, at-risk pregnancies without proper medical guidance can bring forth complications that increase the risk for IUFD. Medical complications arising from preexisting risk factors that can cause intrauterine fetal demise include:
| COMPLICATION | DESCRIPTION | ASSOCIATED RISK FACTORS |
| Placental Insufficiency | Reduced blood flow to the placenta, which leads to inadequate fetal nutrition and oxygenation. | Can result from hypertension, diabetes, or autoimmune disorders. |
| Preeclampsia / Eclampsia | Pregnancy-induced high blood pressure with potential organ damage and seizures. | More common in women with chronic hypertension or renal disease. |
| Thrombosis | Formation of blood clots in blood vessels, potentially blocking blood flow to the fetus. | Blood clots can form due to thrombophilias or autoimmune disorders. |
| Severe Maternal Anemia | Critically low red blood cell count, reducing oxygen supply to the fetus. | Can occur in sickle cell disease or other hematological disorders. |
| Uteroplacental Hypoxia | Insufficient oxygen supply to the uterus and placenta affects fetal development. | Can result from cardiovascular diseases or chronic respiratory conditions. |
| Fetal Growth Restriction | The fetus is smaller than expected for gestational age due to poor growth in utero. | Often associated with hypertension, autoimmune diseases, or thyroid disorders. |
| Placental Abruption | Premature separation of the placenta from the uterine wall, which disrupts fetal blood supply. | More common in hypertensive disorders or thrombophilias. |
| Maternal Infections | Various infections can cross the placenta and harm the fetus. | HIV or other conditions that compromise the immune system can increase infection risk. |
| Fetal Congenital Anomalies | Structural or functional abnormalities present at birth, some incompatible with life. | Higher risk in poorly controlled diabetes or certain autoimmune conditions. |
| Umbilical Cord Accidents | Issues with the umbilical cord (e.g., compression, knots) that disrupt fetal blood flow. | May be more frequent in cases of polyhydramnios associated with diabetes. |
| Maternal Organ Failure | Severe dysfunction of vital maternal organs affecting fetal wellbeing. | Severe complications of conditions like renal or liver disease. |
| Acute Fatty Liver | Rare but serious condition causing liver dysfunction in late pregnancy. | More common in women with underlying metabolic disorders. |
| Maternal Arrhythmias | Irregular heart rhythms can compromise blood flow to the fetus. | Can occur due to thyroid disorders or cardiovascular diseases. |
| Severe Hypertensive Crisis | Dangerously high blood pressure can lead to organ damage and fetal distress. | Can result from chronic hypertension or renal disease. |
What are its Signs and Symptoms?
Signs and symptoms of intrauterine fetal demise (IUFD) can be subtle and may not always be immediately apparent. Here are some common indicators:
- Decreased or absent fetal movement
- Vaginal bleeding or spotting
- Abdominal pain or cramping
- Loss of pregnancy symptoms (ie., nausea, breast tenderness, etc.)
- Fever
- Brownish or pinkish vaginal discharge
- Leaking of amniotic fluid
Note that many of these symptoms can also occur in normal pregnancies. Any concerns should be promptly discussed with a healthcare provider for proper evaluation and diagnosis.
Seeking Legal Compensation for IUFD?
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Compensation from Intrauterine Fetal Demise Claims
Before filing your claim, an initial investigation is needed to establish your case. Your birth injury lawyer would need to establish four key elements during this initial investigation. These key elements include:
| 1. Duty of Care – Was there an appropriate doctor-patient relationship? |
| 2. Breach of Duty – Did your doctor perform poorly/negligently based on accepted standards of care? |
| 3. Causation – Did your doctor’s actions/inactions directly cause you harm? |
| 4. Damages – What did these errors cost you? |
When seeking compensation, damages pertain to both economic and non-economic losses that a family has experienced. Medical malpractice compensation for intrauterine fetal demise can include the following:
| Medical expenses - Costs associated with the pregnancy up to the point of IUFD - Expenses for any procedures related to the IUFD (e.g., delivery of the stillborn) - Follow-up medical care, including mental health treatment Loss of earnings - Wages lost due to time off work for medical appointments, procedures, and recovery - Potential future lost earnings if the incident affects the parent's ability to work Pain and suffering - Physical pain experienced by the mother - Emotional distress and mental anguish for both parents Loss of consortium - Compensation for the impact on the relationship between the parents Funeral and burial expenses - Costs associated with laying the stillborn child to rest Wrongful death damages - In some jurisdictions, parents may be able to claim damages for the loss of their child Punitive damages - In cases of gross negligence or intentional misconduct, punitive damages may be awarded to punish the healthcare provider and deter similar behavior Future medical expenses - Costs for ongoing psychological treatment or counseling - Expenses related to fertility treatments or future pregnancies, if applicable Loss of enjoyment of life - Compensation for the impact on the parents' quality of life and ability to enjoy normal activities Cost of household services - If the mother is unable to perform household duties due to physical or emotional trauma |
Speak to a Medical Malpractice Lawyer Today
At the Porter Law Group, our team of proven medical malpractice lawyers delivers ideal results. We take pride in helping families rebuild after unfavorable circumstances. We operate on a contingency basis – meaning you do not need to pay us anything unless we win your case. Through this approach, we can better support families during their times of need.
If you or a loved one has been a victim of medical malpractice, please reach out to us for a non-obligatory free case evaluation. You can also contact us at 833-PORTER9 or info@porterlawteam.com to schedule a consultation.
