Quibel T, Bultez T, Nizard J, Subtil D, Huchon C, Rozenberg P
Service de gynécologie-obstétrique, CHI Poissy-Saint-Germain-en-Laye, 10, rue du Champ-Gaillard, 78300 Poissy, France.
Service de gynécologie-obstétrique, CHI Poissy-Saint-Germain-en-Laye, 10, rue du Champ-Gaillard, 78300 Poissy, France.
J Gynecol Obstet Biol Reprod (Paris). 2014 Dec;43(10):883-907. doi: 10.1016/j.jgyn.2014.09.018. Epub 2014 Nov 6.
To give consistent data of the prevalence of intrauterine fetal death (IUFD), to assess risk factors and causes related to IUFD, to evaluate prevention of IUFD, to evaluate fetal autopsy and MRI and to determine the management of inhibition of lactation.
French and English publications were searched using PubMed, Cochrane Library.
Intrauterine fetal death occurs in 2% of the pregnancies worldwide, and in around 0,5% of pregnancies in France (NP1). Major risk factors related to IUFD are maternal overweight, maternal age, and smoking, small for gestational age fetuses or placental abruption, and pre-gestational maternal diseases such as hypertension and diabetes (NP1). The most relevant causes of IUFD are placental anomalies, followed by abnormal karyotypes and congenital malformations (NP3). Data are insufficient to recommend a classification for causes of IUFD. Data concerning primary and secondary prevention do not recommend a specific management for the following of pregnancy. Fetal autopsy is still the gold standard of fetal examination, but fetal post-mortem MRI can be offered when fetal autopsy is refused (NP4). Inhibition of lactation should be started within 24hours postpartum with cabergoline, if the patient demands a treatment (NP4).
提供关于宫内死胎（IUFD）患病率的一致数据，评估与IUFD相关的危险因素和原因，评估IUFD的预防措施，评估胎儿尸检和磁共振成像（MRI），并确定抑制泌乳的处理方法。
使用PubMed、Cochrane图书馆检索法语和英语出版物。
全球范围内2%的妊娠会发生宫内死胎，在法国约0.5%的妊娠中出现（国家健康保险数据1）。与IUFD相关的主要危险因素包括孕妇超重、孕妇年龄、吸烟、小于胎龄儿或胎盘早剥，以及孕前孕妇疾病如高血压和糖尿病（国家健康保险数据1）。IUFD最相关的原因是胎盘异常，其次是染色体异常和先天性畸形（国家健康保险数据3）。关于IUFD病因分类的数据不足。关于一级和二级预防的数据不建议对后续妊娠进行特定管理。胎儿尸检仍是胎儿检查的金标准，但如果拒绝胎儿尸检，可提供胎儿死后MRI检查（国家健康保险数据4）。如果患者要求治疗，应在产后24小时内开始使用卡麦角林抑制泌乳（国家健康保险数据4）。
