North American Registry of Midwives (NARM) Practice Exam

What typically triggers the onset of labor following intrauterine demise?

1. Increased fetal movement

2. Cessation of placenta function

3. Hormonal changes

4. Infection

The correct answer is: Cessation of placenta function

The correct answer is the cessation of placenta function. When intrauterine demise occurs, the placenta, which has been supporting the pregnancy, ceases to function effectively. This loss of placental function leads to a series of physiological changes in the body, including a decrease in the production of hormones that are normally associated with supporting the pregnancy and initiating labor. As the placenta deteriorates, it can trigger the body to enter labor, as it recognizes that the conditions typical for pregnancy are no longer present. In this context, the other options don't accurately reflect the primary mechanism that leads to the onset of labor after intrauterine demise. Increased fetal movement would not be relevant since fetal movement ceases after demise. Hormonal changes do occur but are secondary effects stemming from the loss of placental function. Infection can cause labor in some circumstances, but it is not a typical trigger immediately following intrauterine demise. Thus, the cessation of placental function remains the key factor in initiating labor in this scenario.