IUD

Question 1

What is an intrauterine death?

Answer 1

Death of a foetus at any stage after the 1st trimester (12/40) and before the onset of labour

Question 2

What is a late foetal loss?

Answer 2

A baby born between 22+0 and 23+6 with no signs of life

Question 3

What is a stillbirth?

Answer 3

A baby born after 24/40 showing no signs of life

Question 4

What is a neonatal death?

Answer 4

A live baby born at 20/40 or later (or with BW >400g) who died before 28 completed days after birth

Question 5

What is a perinatal death?

Answer 5

Stillbirths and neonatal deaths in the 1st week of life

Question 6

When does a stillbirth not need to be registered?

Answer 6

• If <24/40

- If foetal papyraceous is discovered at birth

Question 7

What is a foetal papyraceous?

Answer 7

A mummified foetus

Question 8

What are the 4 elements of the Saving Babies Lives care bundle?

Answer 8

1. Reduce smoking in pregnancy
2. Risk assessment and surveillance for foetal growth restriction
3. Raising awareness of RFM
4. Effective foetal monitoring during labour

Question 9

What are some ways in which mothers may detect an IUD?

Answer 9

• Reduced/absent FM
• PV bleeding
• Abdominal pain
• Premature labour
• Offensive discharge
• Feeling that ‘something is wrong’

Question 10

What are some ways in which midwives may detect an IUD?

Answer 10

• No change in fundal height
• SGA
• Rigid, painful abdomen that’s difficult to palpate
• Unable to auscultate FHR

Question 11

Why should delivery of an IUD not be delayed?

Answer 11

Increasing risk of APH

Question 12

What are some maternal causes of perinatal death?

Answer 12

• Infection
• Cord problems (e.g. prolapse, true knot)
• Placental separation/ insufficiency

Question 13

What are some foetal causes of perinatal death?

Answer 13

• Hypoxia
• Prematurity
• RDS
• Meconium aspiration
• Failed resuscitation
• Rhesus disease

Question 14

How should the 1st episode of RFM be managed?

Answer 14

• Midwife review
• SHO review if still not happy after CTG
• CTG for 30 mins - 1 hour (looking for movements and must meet Dawes-Redman criteria)

Question 15

How should subsequent episodes of RFM be managed?

Answer 15

Reg review