A Retrospective Analysis of Intrauterine Foetal Demise Cases in a Tertiary Care Hospital: Insights into Maternal Factors and Obstetric Outcomes

Objectives The objective of this study is to investigate maternal factors and obstetric outcomes associated with intrauterine fetal demise (IUFD) at a tertiary care center in Mangaluru, India, with the aim of identifying key determinants to improve antenatal care and reduce the incidence of stillbirths. Material and Methods A retrospective observational study was carried out in the Department of Obstetrics and Gynaecology at K.S. Hegde Medical Academy over a six-year period (2019–2024). The analysis included 66 cases of IUFD/stillbirths occurring beyond 24 weeks of gestation. Cases were categorized using the Re. Co. De. classification system. The study examined maternal, fetal, placental, and socioeconomic factors. Ethical approval was obtained, and all patient data were anonymized to maintain confidentiality. Results Among 12,205 total deliveries during the study period, the IUFD/stillbirth rate stood at 5.41%. Notable maternal risk factors included advanced maternal age (30–34 years), nulliparity (42%), and irregular antenatal care attendance (38%). A significant proportion of affected cases belonged to lower socioeconomic strata. Maternal medical conditions contributing to IUFD included gestational diabetes mellitus (15.15%), hypertensive disorders of pregnancy (9.09%), and anemia. Fetal causes such as congenital anomalies and intrapartum asphyxia were observed, along with placental pathologies like chronic uteroplacental insufficiency. When classified using the Re. Co. De. system, 39.39% of IUFD cases were linked to maternal conditions, while 18.18% remained unexplained. Conclusion IUFD emerges as a complex, multifactorial issue shaped by maternal health, fetal conditions, and placental pathology. This study underscores the critical role of consistent antenatal care and the timely management of high-risk pregnancies. Socioeconomic disparities remain a key concern, emphasizing the need for targeted public health interventions, including preconceptional counselling and comprehensive prenatal support. Understanding these interconnected factors can guide actionable steps to reduce the stillbirth burden and improve overall pregnancy outcomes.