? about fetus that died in womb

ktwlpn, LPN · Apr 30, 2006

Hey everyone! I just have some questions what I discussed with coworkers:
A fellow coworker told me a pregnant friend of his the fetus had died. They did I believe an US (I don't know how old the fetus is) and no heartbeat. So they were going to remove the fetus the next morning.
1. My question is what is the time frame to remove the fetus if it has died or if the fetus is even removed? My coworker feels the fetus should have been removed that day and his friend shouldn't have to wait an entire day.
2 and 3. My other question is while the fetus is dead will it harm the mother staying inside? I thought there could be risk of infection and other issues like the fetus detaching causing bleeding issues but I also thought the fetus is still recieving supplies from the mother so how long can that last? I thought if the fetus is almost to full term the baby is delivered naturally?
My coworker feels it was unethical instead of removing the fetus that day to remove it the next day. My coworker even further states the nurse involved should have acted as a pt advocate and demanded the dead fetus be removed in that same day. Now maybe I'm missing something. I don't know if it was a reg checkup or if she was hospitalized. All I know is the fetus died in the womb, staff were to remove it the next day and my coworker feels that is unethical. Is that true?? I don't think so. I understand the mother being distraught but to even demand the nurse do more?
I told him I thought you normally remove the fetus but not 100% positive when they deterimine this. Unless there was bleeding isn't one day resonable? I'm sure the mother is a wreck but there are other procedures the staff do. Any thoughts?

It's not about your co-workers feelings-it's about the mother and father....Nurses should not shoot their mouths off about things they obviously don't know....We can do ALOT of harm because of ignorance...This woman is devastated-she is experiencing all of the feelings that go along with a fetal demise-does she need the added burden this "friend" may be laying on her? I don't think so-he needs to shut his trap...Every situation is different-too many variables to discuss here.Tell your co-worker to be supportive of his friend...and remind him it's not about his feelings.....

LilPeanut, MSN, RN, NP · Apr 30, 2006

It also an depend on the age of the fetus, I believe. I know I've heard some places prefer to wait, especially in the earlier gestations because of the very off chance that some sort of mistake was made and they want to ensure that yes the fetus is dead.

No matter what though, it's a terrible loss and she has my sympathy, as do any mother who have had to suffer it.

nursedude1 · Jul 24, 2006

Wow.

What an utterly thoughtless and completely inappropriate comment your friend made. I hope this wasn't within earshot of the patient.

Like others here, I have personal experience (as a father) in this sort of matter. My wife still emotionally suffers from the loss of our daughter (full term, no rational cause) even 2+ years later (and probably will for a very long time). The uninitiated often think that the mother's reaction should be to "get that dead baby out of my belly". It is almost invariably the exact opposite. That mother has spent long months (sometimes years, if you count pre-conception) waiting for that tiny new life to become a real part of their day-to-day life, and in a few cruel moments, that hope is torn from her very soul. She needs time to process the loss and work her way through the inevitable disbelief before having her child taken from her. The physiological risks in most cases are negligible. She will suffer the loss over and over in her mind for years to come. Your friend needs to realize that although the child has died, he/she is no less a person.

On a similar note, I have run into similar attitudes when it comes to parents wanting to keep the child with them for a time. In trying to remember that most nurses don't know what it's like to lose a child before you've gotten an opportunity to know them, I remind them that if it were their child, they'd probably have trouble letting go too. I do whatever I can to facilitate the parents' grieving process.

Oh, and for all of you nurses that do have the privilege of caring for these folks, a special request - PLEASE DON'T FORGET ABOUT THE DADS!

suebird3 · Jul 24, 2006

My condolences.

Waaay back, a childhood friend's mom was pregnant, and learned at 7 1/2 months that her baby was dead, and had to carry it to term. This was back in the late 60's. Tragic, all around.

Suebird

CHATSDALE · Jul 24, 2006

horrible situation

maybe what upset the friend is that the mother was really not given a choice and later was upset and told him that she wished that the induction or d/c would have been done at once

some medical people can be insensitive this is an everyday event to them and it is the most traumatic situation that the patient has ever been subjected to

my condolences to all who have been in this situation

dragonflyRN · Jul 24, 2006

Maybe it was different for me. Everything was "normal" until I was over 4 months along. Then they could not find the kidneys. At 6 months I had to end the pregnancy. Renal Agenesis. Look it up. 13 years ago....asked if there was anything I could do...give a kidney to my baby...was told no.

Alixandra · Jul 24, 2006

My sister in law lost her baby at 18 weeks. She went in for a routine ultrasound at 18 weeks and they found the baby was dead. This was a shock to the entire family since you figure once the first trimester is over you have nothing to worry about. My own dr told me(I was 14 weeks pregnant when she lost her baby) at 10 weeks when I saw my son's heartbeat that once you see the heartbeat there is only a 5% chance of losing the baby.

She was scheduled for an induction the next day and on the way in for it her water broke and she delivered her daughter lady partslly a short time later. IOt was horrid ordeal because they told her she had a boy and she said it looked like the baby had a tiny member and it wasn't until they got the DNA back that they discovered she had a really had a little girl. They did all the work ups, DNA, autopsy, etc and they never did find out why the baby died. Waiting gave my mother in law time to come up since she lived over 4 hours way and had to get time off of work and her husband(who was there for the ultrasound) time to get several days off of work to support sister in law.

She said she was in shock and didn't really pay attention to her choices, and it was really her husband's decision(she just went along with it) to wait as he knew she would need to have the support of her mother when this happened.

She said she feels it was best to wait, she wouldn't have been able to deal with it if she would have been sent at that moment for an induction.

Horrible situation no matter how you look at it. I'm sorry for everyone's losses.

I had a very early miscarriage, I was no more than 2-4 weeks along, I found out I was pregnant by a fluke and was told(I wasn't given a a choice they told me this was what I was going to do) to let nature take it's course and finally got sick of waiting(4-6 weeks later) for nature so I went on the pill and 4 weeks later miscarried the baby when I started my period. I think the woman should be given a choice of what she wants to do. I didn't want to walk around waiting for nature to take it's course, especially after 4-6 weeks of waiting(I knew I wasn't pregnant because I caught pnemonia a week after I was informed that i had lost the baby and the pregnancy test was negative) which is why I grabbed a pack of pills I had around(I got pregnant on the shot) to get it over and done with.

Taryn

RNfromMS · Jul 24, 2006

This is always a sad situation. We have IUFDs at my hospital way too often for my sanity, but usually as soon as it is discovered (in clinic or triage), they admit the patient and start induction. I find that a lot of people (some staffers, some family members) don't understand why the patient would be subjected to labor only to deliver a dead fetus. They think she should just be given a c-section so that she can get it over with.

But the real reason for my post: My sister was pregnant in 1989 with her fourth pregnancy. She had delivered a beautiful little girl in 1986 after several years of trying to get pregnant and then miscarried two times after that. About two and a half monts into this pregnancy, she had a period of very heavy lady partsl bleeding and went to the doctor. She was told she had miscarried and they scheduled for her to have a d&c done the following week. When she went in for the d&c, they did blood tests and USG per protocol prior to starting procedure and found that she was still pregnant. At 31-2/7 weeks, she SROM'd at work and went to doctor. They sent her to the hospital where she received antibiotics for PPROM and steroids for five days. On the 5th day (32 weeks), they did another USG and found the baby to be breech so decided to c-section her then. Not only was the baby actually not breech, but while the placenta was firmly in place in the fundus, the baby was lying inside the fallopian tube (right at the opening). She was 3 lbs 3 oz and spent 4 weeks in the NICU. She is now 16 years old, 5' 8" tall and weighs about 180 pounds (due to Hashimoto's syndrome).

DutchgirlRN, ASN, RN · Jul 25, 2006

My question is what is the time frame to remove the fetus if it has died or if the fetus is even removed? My coworker feels the fetus should have been removed that day and his friend shouldn't have to wait an entire day.

In 1978 I was pregnant, my hubby was in the Navy, we were stationed in Virginia Beach. The prenatal care was awful but at the time I didn't not know it. When the heartbeat was supposed to be heard it wasn't. The Corp person said that's ok we'll hear it next month. I had just begun to show and feel as though the pregnancy was lost around 16 weeks gestation.

At my 5 months check-up still no heartbeat. An ultrasound was done and only a gestational sac was seen. This doctor said I think you've gotten pregnant again and we can't remove anything (Now I know what idiots they were but at the time I was believing them). By my 6 months check-up or whatever they considered it, my pregnancy test was negative. They put me on a list for a D&C which was 3 weeks from that or 28+ weeks gestation supposedly.

Emotionally I could not handle it anymore and I got on a plane and flew home to my parents, my hubby took emergency leave. Being so far away from a base the Navy had to pay for private medical care. I was in the hospital the following day and had a D&C. I was told that the results were a small fetus that had deteriorated to the point that it was broke up into sections and that I was "extremely" lucky to not have become toxic from my own fetus.

Once hubby was out of the Navy and we had private insurance we had a healthy girl and a healthy boy. Now 25 y/o and 17 y/o. We did lose one little girl between our two children due to placenta previa but thankfully I received excellent care. If I could go back in time I would have taken legal actions to prevent such horrendous care to happen to any other women.

unikuelady, RN · Jul 25, 2006

:flowersfo There was a patient a few years back that was sent to the L&D unit from her OB's office for ultrasound. 35 weeks and no heartbeat. The MD talked to the patient and family with all of the options available to her. Immediate induction to deliver now, wait until the next day. Risks were discussed on waiting. The patient wanted to go home and said she would come back in the morning. She did not show up for the appointed induction. The MD contacted her at home and she supposedly refused to come in, in denial that the baby was deceased. 4 days later she shows up in the ER with a high fever, nearly comatose. She is rushed to the OR for C/S. She died that night in the ICU of fulminate sepsis-caused by the baby degrading inside of her. This case has shown me the magnitude of support that these women need to deal emotionally with a fetal death. I have become the fetal death counselor/nurse specific to caring for these families, helping them to first be a parent to their child and the ability to let the child go. I help them make memories and their child real.....not just a products of conception or fetus. The loss of a child is hardest thing to handle as a parent. healing does come. The thing that they will always remember is how they were treated by the hospital staff during this difficult time.

trixie22 · Jul 25, 2006

It depends on the age of the fetus as well. It is not unethical to have waited a day before removing the fetus. The body might eventually rejecting the fetus and go into labor naturally. Sometimes though this doesn't happen, and the longer the fetus is inside, the increased risk you have for infection. Sometimes too, waiting a day can help a family deal with the death process. To go from being pregnant to all of a sudden not having a baby can be very traumatic. More than likely, it was a matter of scheduling surgery etc. Hope this helps.

kade1 · Aug 22, 2010

We had a lady at the Ob/gyn office who had an ultrasound at 9.3 weeks and there was no heartbeat, after sending her to another office it was confirmed, she called the next day and wanted a D & C right away and was told she had to wait for two weeks till they could fit her in. The lady was very distraught, and I wanted to tell her to go to the E.R. and see if would help. What would you have done?