Factors Related to Late Intrauterine Fetal Death in a Tertiary Level Hospital: A Retrospective Study

Abstract

Background: Intrauterine fetal death (IUFD) is an unfortunate perinatal occurrence with serious global and local impacts. Despite improved diagnostic methods, a significant fraction of stillbirths remains unexplained, especially in resource-constrained settings such as Nepal. Thus, the present study aimed to determine the frequency and associated characteristics of late intrauterine fetal death (?28 weeks) in a tertiary-level hospital in Nepal.
Methods: A retrospective descriptive study was conducted at Dhulikhel Hospital, Nepal, from January 2024 to January 2025. Medical records from 36 women with late IUFD (?28 weeks of gestation) were reviewed. Data on sociodemographic variables, obstetric history, antenatal care (ANC) attendance, and fetal factors were gathered and analyzed using descriptive statistics.
Results: The mean maternal age was 27.3 ± 6.3 years, with most women (88.9%) in the age group between 20-34 years. The majority were multigravida (80.6%) and had attended at least four ANC visits (83.3%). The mean gestational age at delivery was 35.8 ± 4.1 weeks, with a mean fetal birth weight of 1905±834 grams. 41.7% of fetuses weighed less than 1500 grams. Male fetuses prevailed (61.1%). Surprisingly, 80.6% of instances were unexplained. Fetal malpresentation (8.3%), hypertensive disorders (5.6%), and other maternal comorbidities were all identifiable variables.
Conclusions: This study highlights a high proportion of unexplained stillbirths despite appropriate antenatal care in a tertiary care setting.
Keywords: Antenatal care; intrauterine fetal death; perinatal mortality; stillbirth.