Managing Complications in Pregnancy and Childbirth: - IAWG

S-132 Loss of fetal movementsDIAGNOSISTABLE S-19Diagnosis of loss of fetal movementsPresenting Symptom andOther Symptoms and SignsTypically PresentSymptoms and SignsSometimes PresentProbable Diagnosis• Decreased/absent fetalmovements• Intermittent or constantabdominal pain• Bleeding after 22 weeksgestation (may be retained inthe uterus)• Absent fetal movements andfetal heart sounds• Bleeding (intra-abdominaland/or vaginal)• Severe abdominal pain (maydecrease after rupture)• Decreased/absent fetalmovements• Abnormal fetal heart rate(less than 100 or more than180 beats per minute)• Absent fetal movements andfetal heart sounds• Shock• Tense/tender uterus• Fetal distress or absentfetal heart soundsAbruptio placentae,page S-18• ShockRuptured uterus,• Abdominal distension/ free page S-20fluid• Abnormal uterine contour• Tender abdomen• Easily palpable fetal parts• Rapid maternal pulse• Thick meconium-stainedfluid• Symptoms of pregnancycease• Symphysis-fundal heightdecreases• Uterine growth decreasesFetal distress, pageS-95Fetal death, pageS-132FETAL DEATHIntrauterine death may be the result of fetal growth restriction, fetalinfection, cord accident or congenital anomalies. Where syphilis isprevalent, a large proportion of fetal deaths are due to this disease.• If x-ray is available, confirm fetal death after 5 days. Signs includeoverlapping skull bones, hyper flexed spinal column, gas bubblesin heart and great vessels and oedema of the scalp.