Main Question:
Does intrauterine fetal death (IUFD) predispose women to a higher level of silent
inflammation than selective termination of a singleton pregnancy (feticide)?
Methods:
In this retrospective cohort study, we examined maternal inflammatory parameters prior
to delivery and compared results on C-reactive protein (CRP), neutrophils and leucocytes
between women after IUFD versus feticide. Cases with apparent maternal or fetal infection
were excluded.
Results:
The study cohort comprises 180 cases of IUFD between 21+0 and 41+3 gestational weeks
(GW), as well as 148 feticides between 17+0 and 36+5 GW. Maternal age (mean ± SD)
of women after IUFD was 31.37 ± 0.49 years and 30.67 ± 0.51 years after feticide,
respectively (p = 0.33). CRP was found to be significantly higher in women after IUFD
compared to feticide (1.80 ± 0.2 vs. 0.68 ± 0.06; p < 0.0001), as were the absolute
neutrophil counts (7.73 ± 0.2 vs. 7.2 ± 0.17; p = 0.04). Also, leucocytes were significantly
higher in women after IUFD compared to feticide (11.4 ± 0.29 vs. 9.92 ± 0.22; p <
0.0001).
Conclusion:
Whilst no correlation between fetal maceration grades and inflammatory parameters
was previously found, in this study, we show that women after IUFD elicit higher values
of inflammatory parameters, compared to women after feticide.
