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Abstract Stillbirth is one of the most traumatic consequences of pregnancy. It is distressing when it occurs without warning. It is defined as fetal death at a gestational age of 20 completed weeks or greater, or if fetal weight is 300 gm. or more. The aim of study was to determine the incidence of intrauterine fetal death and the related risk factors among high-risk pregnant women. Design.A descriptive correlational design was adopted for this study. Setting. The study was conducted at casualty and high-risk pregnancy departments at Manial University Hospital affiliated to Cairo University. Sample. Both prospective and retrospective sampling was used. A total of 450convenient sample of high-risk pregnant women was selected through a period of one year (from February, 2019 to January 2020) and additional sample was selected retrospectively from archived patient files during the period prior to the study (from February, 2018 to January, 2019). Results: The incidence of intra-uterine fetal death was 19.02/1000 birth in 2018 and 11.4/1000 birth in 2019. The reported causes of IUFD by medical records were preeclampsia and antepartum hemorrhage. The significant risk factors associated with IUFD were cardiac disease (X2 = 29.03, p= 0.000), previous IUFD (X2 = 27.0, p= 0.000), previous abortion (X2 = 8.55, p= 0.003), gravidity (r= 0.133, p= 0.005), oligohydramnios (X2 = 5.26, p= 0.022), maternal age (r= 0.096, p= 0.041) & residence (X2 = 3.66, p= 0.05). Conclusion: there was noticeable decrease in the number of IUFD to 11.4 per 1000 birth compared to 2018, Preeclampsia, antepartum hemorrhage were major causes of IUFD, risk factors included cardiac disease, previous IUFD, previous abortion, gravidity, oligohydramnios, age and residence. Recommendations; increase pregnant women’s awareness regarding to IUFD. Emphasis on antenatal visits and the benefits of regular attendance for early detection and management of high-risk conditions |