Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, MD, FRCOG, Joachim W.

Ed. by Bancalari, Eduardo / Chappelle, Joseph / Chervenak, Frank A. / D'Addario , Vincenzo / Genc, Mehmet R. / Greenough, Anne / Grunebaum, Amos / Konje, Justin C. / Kurjak M.D., Asim / Romero, Roberto / Zalud, MD PhD, Ivica

IMPACT FACTOR 2018: 1.361
5-year IMPACT FACTOR: 1.578

CiteScore 2018: 1.29

SCImago Journal Rank (SJR) 2018: 0.522
Source Normalized Impact per Paper (SNIP) 2018: 0.602

See all formats and pricing
More options …
Volume 46, Issue 1


Causes of intrauterine fetal death are changing in recent years

Hiroko Takita / Junichi Hasegawa
  • Corresponding author
  • Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan
  • Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kanagawa, Japan
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Masamitsu Nakamura / Tatsuya Arakaki / Tomohiro Oba / Ryu Matsuoka / Akihiko Sekizawa
Published Online: 2017-02-25 | DOI: https://doi.org/10.1515/jpm-2016-0337



To investigate, how causes of intrauterine fetal death (IUFD) have changed in recent years with the advancement of prenatal diagnosis at a single perinatal center in Japan.


Medical records were retrospectively reviewed for all cases of IUFDs that occurred between 2001 and 2014. The most commonly associated causes of fetal deaths were compared between 2001–2007 and 2008–2014.


The number of IUFD after 20 weeks’ gestation/all deliveries in our center was 38/6878 cases (0.53%) in 2001–2007 and 35/7326 (0.48%) in 2008–2014. The leading cause of IUFD in 2001–2007 was fetal abnormalities (43.2%), the prevalence of which was only 8.6% in 2008–2014 (P<0.01). Meanwhile, the prevalence of umbilical cord abnormalities was relatively increased from 30.0% in 2001–2007 to 54.5% in 2008–2014 (P=0.06). In 2001–2007, chromosomal abnormalities were frequently observed (56% of IUFDs due to fetal abnormalities). Hyper-coiled cord (HCC) and umbilical ring constrictions were the most frequent cause of IUFD in both periods. The relatively decreased prevalence of IUFD due to velamentous cord insertion and umbilical cord entanglement, HCC and umbilical cord constriction was increased.


The prevalence of IUFD due to fetal abnormalities was reduced, but IUFD associated with umbilical cord abnormalities tended to increase relatively.

Keywords: Chromosome abnormality; fetal anomaly; hypercoiled cord; intrauterine fetal death (IUFD); umbilical cord; velamentous cord insertion


  • [1]

    Carmichael SL, Blumenfeld YJ, Mayo J, Wei E, Gould JB, Stevenson DK, et al. Prepregnancy obesity and risks of stillbirth. PLoS One. 2015;10:e0138549.CrossrefWeb of SciencePubMedGoogle Scholar

  • [2]

    Flenady V, Koopmans L, Middleton P, Froen JF, Smith GC, Gibbons K, et al. Major risk factors for stillbirth in high-income countries: a systematic review and meta-analysis. Lancet. 2011;377:1331–40.Web of ScienceCrossrefPubMedGoogle Scholar

  • [3]

    Kamiya K, editor. Maternal and child health statistics in Japan. Tokyo: Mothers’ and Children’s Health and Welfare Association; 2015.Google Scholar

  • [4]

    Strong TH, Jr., Jarles DL, Vega JS, Feldman DB. The umbilical coiling index. Am J Obstet Gynecol. 1994;170:29–32.CrossrefPubMedGoogle Scholar

  • [5]

    Takita H, Hasegawa J, Arakaki T, Nakamura M, Hamada S, Tokunaka M, et al. Usefulness of antenatal ultrasound fetal morphological assessments in the first and second trimester: a study at a single Japanese university hospital. J Med Ultrasonics. 2016;43:57–62.CrossrefWeb of ScienceGoogle Scholar

  • [6]

    Hume H, Chasen ST. Trends in timing of prenatal diagnosis and abortion for fetal chromosomal abnormalities. AmJ Obstet Gynecol. 2015;213:545 e1–4.CrossrefGoogle Scholar

  • [7]

    Hasegawa J. Sonoembryological evaluations of the development of placenta previa and velamentous cord insertion. J Obstet Gynaecol Res. 2015;41:1–5.Web of SciencePubMedCrossrefGoogle Scholar

  • [8]

    Qin J, Liu X, Sheng X, Wang H, Gao S. Assisted reproductive technology and the risk of pregnancy-related complications and adverse pregnancy outcomes in singleton pregnancies: A meta-analysis of cohort studies. Fertil Steril. 2016;105:73–85 e1–6.CrossrefWeb of ScienceGoogle Scholar

  • [9]

    Raisanen S, Georgiadis L, Harju M, Keski-Nisula L, Heinonen S. Risk factors and adverse pregnancy outcomes among births affected by velamentous umbilical cord insertion: a retrospective population-based register study. Eur J Obstet Gynecol Reprod Biol. 2012;165:231–4.Web of ScienceCrossrefPubMedGoogle Scholar

  • [10]

    Ebbing C, Kiserud T, Johnsen SL, Albrechtsen S, Rasmussen S. Prevalence, risk factors and outcomes of velamentous and marginal cord insertions: a population-based study of 634,741 pregnancies. PLoS One. 2013;8:e70380.CrossrefPubMedWeb of ScienceGoogle Scholar

  • [11]

    Ezimokhai M, Rizk DE, Thomas L. Maternal risk factors for abnormal vascular coiling of the umbilical cord. Am J Perinatol. 2000;17:441–5.CrossrefPubMedGoogle Scholar

  • [12]

    Hasegawa J, Matsuoka R, Ichizuka K, Sekizawa A, Okai T. Ultrasound diagnosis and management of umbilical cord abnormalities. Taiwan J Obstet Gynecol. 2009;48:23–7.CrossrefWeb of SciencePubMedGoogle Scholar

  • [13]

    Skulstad SM, Rasmussen S, Iversen OE, Kiserud T: The development of high venous velocity at the fetal umbilical ring during gestational weeks 11–19. Br J Obstet Gynecol. 2001;108:248–53.Google Scholar

  • [14]

    Hasegawa J. Studies for early identification of umbilical cord abnormalities and for managements of high risk pregnancies with them. Acta Obst Gynaec Jpn. 2008;60:1723–34.Google Scholar

  • [15]

    Takita H, Hasegawa J, Arakaki T, Nakamura M, Tokunaka M, Oba T, et al. Antenatal ultrasound screening using check list before delivery for predicting a non-reassuring fetal status during labor. J Matern Fetal Neonatal Med. 2016:1–21. ahead of print.Web of ScienceGoogle Scholar

  • [16]

    Oyelese Y, Catanzarite V, Prefumo F, Lashley S, Schachter M, Tovbin Y, et al. Vasa previa: the impact of prenatal diagnosis on outcomes. Obstet Gynecol. 2004;103:937–42.PubMedCrossrefGoogle Scholar

  • [17]

    Hasegawa J, Nakamura M, Ichizuka K, Matsuoka R, Sekizawa A, Okai T. Vasa previa is not infrequent. J Matern Fetal Neonatal Med. 2012;25:2795–6.Web of SciencePubMedCrossrefGoogle Scholar

  • [18]

    Hasegawa J, Mimura T, Morimoto T, Matsuoka R, Ichizuka K, Sekizawa A, et al. Detection of umbilical venous constriction by doppler flow measurement at midgestation. Ultrasound Obstet Gynecol. 2010;36:196–201.PubMedCrossrefWeb of ScienceGoogle Scholar

  • [19]

    Predanic M, Perni SC, Chasen ST, Baergen RN, Chervenak FA. Ultrasound evaluation of abnormal umbilical cord coiling in second trimester of gestation in association with adverse pregnancy outcome. Am J Obstet Gynecol. 2005;193:387–94.PubMedCrossrefGoogle Scholar

  • [20]

    Ananth CV, Peltier MR, Kinzler WL, Smulian JC, Vintzileos AM. Chronic hypertension and risk of placental abruption: is the association modified by ischemic placental disease? Am J Obstet Gynecol. 2007;197:273 e1–7.Web of ScienceCrossrefGoogle Scholar

About the article

Corresponding author: Dr. Junichi Hasegawa, Department of Obstetrics and Gynecology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan, Tel.: +81-3-3784-8551, Fax: +81-3-3784-8355

Received: 2016-10-21

Accepted: 2017-01-23

Published Online: 2017-02-25

Published in Print: 2018-01-26

Author’s statement

Conflict of interest: Authors state no conflict of interest.

Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.

Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.

Contribution to authorship: Takita H., Hasegawa J. and Nakamura M. designed the research. All the authors collected the data. Takita H., Hasegawa J. and Arakaki T. analyzed and interpreted the data. Takita H., Hasegawa J. and Sekizawa A. drafted the manuscript. Takita H. and Hasegawa J. performed the statistical analyses.

Funding: None.

Citation Information: Journal of Perinatal Medicine, Volume 46, Issue 1, Pages 97–101, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/jpm-2016-0337.

Export Citation

©2018 Walter de Gruyter GmbH, Berlin/Boston.Get Permission

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

Tinnakorn Chaiworapongsa, Roberto Romero, Offer Erez, Adi L. Tarca, Agustin Conde-Agudelo, Piya Chaemsaithong, Chong Jai Kim, Yeon Mee Kim, Jung-Sun Kim, Bo Hyun Yoon, Sonia S. Hassan, Lami Yeo, and Steven J. Korzeniewski
American Journal of Obstetrics and Gynecology, 2017

Comments (0)

Please log in or register to comment.
Log in