Question

All of the following are true regarding the management of intrauterine fetal death EXCEPT?

• A. In 50% of cases spontaneous expulsion occurs in 2 weeks
• B. Fibrinogen levels should be checked weekly
• C. Delivery by medical induction is preferred if spontaneous expulsion does not occur
• D. Caesarean section has a limited place in the management of intrauterine fetal death

Hint:

Most women (about 80%) go into labour spontaneously within a couple of weeks - the 50% figure is the wrong one.

Answer 1

The Correct Option is A

Step 1: This is a negative (EXCEPT) question, so we must find the one statement that is false about managing intrauterine fetal death (IUFD).

Step 2: After fetal death, spontaneous labour occurs in the large majority of women, with about 80% delivering spontaneously within 2 to 3 weeks. The claim that only 50% expel spontaneously in 2 weeks understates this and is therefore the false statement.

Step 3: The other statements are correct. With prolonged retention there is a risk of disseminated intravascular coagulation, so fibrinogen and coagulation should be monitored periodically. If spontaneous expulsion does not occur, medical induction (for example with prostaglandins) is the preferred route.

Step 4: Caesarean section is reserved for special indications only and has a limited role, so option D is also true. The exception is option A.