A 30-Year-Old Pregnant Woman with Intrauterine Fetal Death

A 30-year-old primigravida was admitted to the hospital in active spontaneous labor at 39.7 weeks' gestation.

The patient had received prenatal care at this hospital since 11.1 weeks' gestation. She had been well. She had had varicella and had received bacille Calmette–Guérin (BCG) vaccine as a child. Four years earlier, a tuberculin skin test had been positive, and a chest radiograph had been negative; she had received antituberculosis medication for 6 months. There was no history of sexually transmitted diseases, and she did not smoke cigarettes, drink alcohol, or use intravenous drugs. She was born and raised in West Africa and had immigrated to the United States 7 years earlier. She had returned to Africa twice in the previous 3 years, most recently 2 months before the first prenatal visit, and had not received pretravel vaccinations or malaria prophylaxis. Her father had type 2 diabetes mellitus.

Diagnosis: Stillbirth due to congenital group B streptococcal infection.