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There are many reasons why a formal ultrasound may be requested in cases of suspected FDIU.
National, and many international guidelines on management of stillbirth state that evaluation following a stillbirth include fetal autopsy, gross and histologic exam of the placenta, umbilical cord and membranes, and genetic studies. A formal scan could assist with confirming FDIU on a high resolution machine, identifying location of placenta, fetal position (which can help the Ob/Gyns plan delivery), identifying gross features such as oligohydramnios/polyhydramnios/skeletal or any other anomalies in the fetus/placenta that may not be identified at bedside ultrasound, as this can help guide further investigations. It may also help identify other causes, such as IUGR. The thought of an autopsy can be very distressing to parents, so not all parents are willing to go through the autopsy, hence maximizing info through ultrasound may be helpful for future management.
There have a rare number of instances (particularly in cases where imaging was difficult eg. obesity, or where TV scanning was not performed), where fetal heart motion was missed or vice versa. Clinicians sending these referrals may want to eliminate any trace of doubt and share the burden of responsibility. Additionally, it is often requested by the patient and their partner to also be in no doubt about the findings.
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There are many reasons why a formal ultrasound may be requested in cases of suspected FDIU.
National, and many international guidelines on management of stillbirth state that evaluation following a stillbirth include fetal autopsy, gross and histologic exam of the placenta, umbilical cord and membranes, and genetic studies. A formal scan could assist with confirming FDIU on a high resolution machine, identifying location of placenta, fetal position (which can help the Ob/Gyns plan delivery), identifying gross features such as oligohydramnios/polyhydramnios/skeletal or any other anomalies in the fetus/placenta that may not be identified at bedside ultrasound, as this can help guide further investigations. It may also help identify other causes, such as IUGR. The thought of an autopsy can be very distressing to parents, so not all parents are willing to go through the autopsy, hence maximizing info through ultrasound may be helpful for future management.
There have a rare number of instances (particularly in cases where imaging was difficult eg. obesity, or where TV scanning was not performed), where fetal heart motion was missed or vice versa. Clinicians sending these referrals may want to eliminate any trace of doubt and share the burden of responsibility. Additionally, it is often requested by the patient and their partner to also be in no doubt about the findings.
As discussed in the below article point of care ultrasound 'should not be considered a substitute for formal diagnostic ultrasound'. Point of care ultrasound in obstetrics: https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/ajum.12133