TheAnswerPage/Obstetrics & Gynecology Friday May 16, 2008 This week: Intrauterine Fetal Demise (IUFD)

A healthy 37-year-old G2P1000 presents to your office at 16 weeks' gestation. Her prior pregnancy was complicated by an unexplained intrauterine fetal demise (IUFD) at 37 weeks' gestation. Despite your best efforts, she presents again at 31 weeks with decreased fetal movements for 12 hours. Ultrasound examination confirms an IUFD. She is particularly interested in identifying the cause of the IUFD.

1. What is the single most important test in identifying the cause of an IUFD?
2. What test should be performed immediately as it cannot be done a few weeks later?
3. Is there any utility in doing a fetal karyotype?
4. What other test might be useful, and when should they be performed?

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