* There is talk of retention after 48 hours from the fetal death.
The essential character of the MIU is to be aseptic.
This does not happen in case of death during labor (intrapartum mortality) after the opening of the egg (septic death).
* Effect of retention:
● Mummification: During the 4th month, the fetus dries, amniotic fluid decreases and disappears …
● maceration: Beyond the 5th month; after the 3rd day of death, begins epidermal uprising, a serous off the skin.
● Biologically: the release of active thromboplastin from the egg gradually leads to disseminated intravascular coagulation status “DIC” (if retention> 15 days).
* Diagnosis:
The quickening have ceased to be perceived, stomach decreased volume, negative cardiac activity on ultrasound.
Milk instead of colostrum (sign value but inconstant).
Ultrasonography: skull image by double contour, flattening of the arch and asymmetry, there is a clear band between the bone and the scalp, fetal immobility.
Radiography in objective Late retention overlapping skull bones (sign Spalding) and pronounced curvature or angulation of the spine.
* Uterine evacuation:
Uterine contractions are often insufficient; the pockets of the particular aspect of water wallet, amniotic fluid is thick and brown; relative frequency of presentations of the forehead and shoulder.
The retention of the decidua is common.
