Expectant management for women with intrauterine fetal death during the mid-trimester of pregnancy that was complicated by placenta previa

Abstract

After the mid-second trimester, women with intrauterine fetal death (IUFD) are managed with cervical dilation and vaginal gemeprost or intravenous oxytocin. In women with IUFD complicated by placenta previa, unneglectable concerns about massive bleeding during the procedure pose a burden on healthcare providers. Although a standardized management remains unestablished, the treatment options for IUFD complicated by placenta previa include cesarean section, gemeprost, and intravenous oxytocin, and such procedures follow uterine artery embolization. However, these strategies have non-negligible risks, such as bleeding during the procedure and adverse effects on future pregnancies. Herein, we present a case of a woman with IUFD at 24 weeks of gestation and complete placenta previa, who delivered a baby with a low blood loss volume after 40 days of expectant management, potentially attributed to placental migration and reduced placental blood flow volume.