Management of Intrauterine Fetal Demise Cases: A Retrospective Analysis

Aim: To evaluate the management process and short-term maternal outcomes of pregnant women treated for intrauterine fetal demise (IUFD) at our institution, and to compare maternal outcomes according to the mode of delivery.Methods: In this single-center, retrospective, observational study, 115 cases at ≥20 weeks of gestation with absent fetal cardiac activity on ultrasonography (US) whose management was completed at the same center were analyzed. Demographic/obstetric characteristics and maternal morbidity outcomes (postpartum curettage, blood transfusion, additional interventions due to postpartum hemorrhage, intensive care unit [ICU] admission) were assessed, and surgical procedures performed for various indications were described. Multivariable logistic regression models were constructed to identify factors associated with cesarean delivery and severe maternal morbidity.Results: The mean maternal age was 31.0±6.9 years, and the median gestational age was 32.5 (27.1–35.5) weeks. Induction of labor was performed in 55.7% of cases (most commonly misoprostol, 37.4%). Deliveries occurred vaginally in 74.8%. The median time from admission to delivery was 4.5 (1.4–15.3) hours, and the median length of hospital stay was 2.0 (2.0–3.5) days. Placental pathology examination was performed in 67.0% of cases, with abnormal findings identified in 60.9%. Postpartum curettage was required in 37.4%, blood transfusion in 18.3%, ICU admission in 8.7%, and severe maternal morbidity occurred in 20.0%. Compared with the vaginal delivery group, the cesarean group had a greater hemoglobin decrease, higher transfusion requirement, and more frequent ICU admission (p