Analgesic treatment of vaginal delivery for late termination and intrauterine fetal demise during the second or third trimester of pregnancy

2012 ◽  
Vol 27 (2) ◽  
pp. 320-321 ◽  
Author(s):  
Rui Matsumine ◽  
Hiroyuki Sumikura
Keyword(s):  
Vaginal Delivery ◽  
Third Trimester ◽  
Fetal Demise ◽  
Analgesic Treatment ◽  
Intrauterine Fetal Demise

scholarly journals Preinduction cervical ripening with vaginal misoprostol in second and third trimester intrauterine fetal demise

2019 ◽  
Vol 14 (2) ◽  
pp. 57-61
Author(s):  
Rakshya Parajuli ◽  
Madhu Shrestha ◽  
Gehanath Baral
Keyword(s):  
Side Effects ◽  
Vaginal Delivery ◽  
International Federation ◽  
Cervical Ripening ◽  
Bishop Score ◽  
Third Trimester ◽  
Fetal Demise ◽  
Trimester Pregnancy ◽  
Intrauterine Fetal Demise ◽  
Vaginal Misoprostol

Aim: To study the effectiveness of vaginal misoprostol according to the FIGO 2017 guideline for preinduction cervical ripening in second and third trimester pregnancy with intrauterine fetal demise. Methods: During six months period from October 2017 to April 2018 at Paropakar Maternity and Women's Hospital, Thapathali, Kathmandu, Nepal, cases admitted for second and third trimester termination of pregnancy for fetal demise were studied using the International Federation of Gynaecology and Obstetrics (FIGO) recommended doses of vaginal misoprostol. For gestational age of 13-26 weeks 200µg, for 27-28 weeks dose of 100µg and for >28 weeks dose of 25µg, every 6 hours was used. Main outcome measured included change in modified Bishop Score, insertion of first dose of vaginal misoprostol to delivery interval and maternal side effects. Results: In this study including 54 cases, mean preinduction Bishop score was 2.12. Bishop score remained unchanged in 2 cases, 28 had score between 4 to 6, 10 cases had score between 7 to 8 and 14 cases had Bishop score more than 8. The change in Bishop Score is statistically significant (p=0.007). 50 cases had vaginal delivery and it occurred within 19.83±13.1 hours. It took minimum 3 hours to maximum 52 hours from the first dose of misoprostol to delivery of the fetus. No side effects were noted within 24 hours of the last dose of vaginal misoprostol. Conclusions: Vaginal misoprostol according to FIGO guideline 2017 is safe and effective for preinduction cervical ripening in second and third trimester intrauterine fetal demise leading to successful vaginal delivery.

scholarly journals Echogenic Intestine: a Case of Intrauterine Fetal Demise at Term

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S24-S25
Author(s):  
E Panah ◽  
B Zelman ◽  
K Gvozdjan
Keyword(s):  
Small Intestine ◽  
Parvovirus B19 ◽  
Postmortem Examination ◽  
Mucosal Inflammation ◽  
Third Trimester ◽  
Fetal Ultrasound ◽  
Fetal Demise ◽  
Female Fetus ◽  
Intrauterine Fetal Demise ◽  
Parvovirus B19 Infection

Abstract Introduction/Objective Parvovirus B19 is a non-enveloped, single-stranded DNA virus that preferentially infects early erythroids, and is commonly associated with second trimester hydrops fetalis. Third trimester non-hydropic intrauterine fetal demise due to parvovirus B19 infection with associated pathologic changes has rarely been described, particularly in the context of IgG seroconverted mother. Methods/Case Report We present a case of a 37 weeks’ gestation stillborn female fetus born to a 29 year-old mother who presented with lack of fetal movement for one day. Fetal ultrasound demonstrated diffuse intestinal echogenicity. Maternal parvovirus B19 IgG level was high (5.48, reference: <=0.90 Index). Postmortem examination revealed a non-dysmorphic fetus. Gross examination was unremarkable. Microscopic examination of small intestine revealed mucosal inflammation and multifocal calcifications. Prominent extramedullary hematopoiesis was present in the liver. Viral cytopathic effect was noted microscopically within nucleated red blood cells present intravascularly within chorionic villi, small intestine, liver, and spleen. Parvovirus B19 infection was confirmed by immunohistochemistry. Results (if a Case Study enter NA) NA Conclusion The cause of clinically puzzling intrauterine fetal demise at term with prominent intestinal echogenicity on ultrasound was determined to be parvovirus B19 infection on postmortem examination. We emphasize the possibility of this diagnostic differential in non-hydropic, third trimester fetal demise in presence of maternal IgG seroconversion and lack of signs of active infection.

Maternal and Fetal Outcomes of COVID-19 Positive Pregnant Women in Government T.D. Medical College Alappuzha

2021 ◽  
Vol 8 (36) ◽  
pp. 3306-3311
Author(s):  
Lalithambica Karunakaran ◽  
Deepthi P.S. ◽  
Shijini T
Keyword(s):  
Maternal Mortality ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Neonatal Outcome ◽  
Full Term ◽  
Fetal Demise ◽  
Medical College ◽  
Intrauterine Fetal Demise ◽  
Corona Virus

BACKGROUND Corona virus disease 2019 (COVID 19) outbreak have evolved rapidly throughout the world. The knowledge on severe acute respiratory disease-corona virus-2 (SARS-CoV-2) infection in pregnant women and newborn is incomplete. Understanding the impact of COVID 19 in pregnancy in terms of morbidity mortality, perinatal and neonatal outcome is essential to propose a strategy for the management of pregnant women with COVID 19 infection. METHOD It is a prospective study of all pregnant women who have delivered in the period of April 2020 to December 2020 at Government T.D. Medical College, Alappuzha. In this study, the mode of delivery, neonatal outcome, maternal mortality, morbidity were evaluated. The outcome of pregnancies includes vaginal delivery, caesarean delivery, vacuum delivery and intrauterine fetal demise. RESULTS A total of 265 pregnant women infected with COVID 19 delivered during the period. Out of these, 49.4 % was full term caesarean delivery, 3.8 % was preterm caesarean delivery, 39.3 % was full term vaginal delivery and 4.9 % was preterm vaginal delivery. Moreover, 1.1 % of the total pregnant women had intrauterine fetal demise on admission. Among 265 new-borns, 2.3 % babies became COVID 19 positive, of this, 83.3 % were mothers who delivered within 7 days of COVID 19 infection. 0.75 % needed resuscitative emergency caesarean delivery for COVID 19 pneumonia. 0.38 % maternal mortality occurred during the period due to COVID 19 infection. CONCLUSIONS Obstetric outcome in most COVID 19 infected term pregnant patients is comparable to non-COVID 19 pregnant women except for a higher incidence of caesarean delivery. Most of the neonates who became positive were born to mothers delivered within 7 days of COVID 19 infection. Severe morbidity among COVID 19 pregnant women were seen only in a small proportion complicated by COVID 19 pneumonia, who required ventilator support. KEYWORDS COVID 19, Pregnancy, Maternal, Perinatal, Neonatal Outcome

THIRD TRIMESTER INTRAUTERINE FETAL DEMISE AND THROMBOELASTOGRAPHY

1999 ◽  
Vol 90 (Supplement) ◽  
pp. 42A
Author(s):  
Raphael Y. Gershon ◽  
Audrey S. Alleyne ◽  
Kenneth M. Mims
Keyword(s):  
Third Trimester ◽  
Fetal Demise ◽  
Intrauterine Fetal Demise

scholarly journals Placental pathology in COVID-19

2020 ◽  
Author(s):  
Elisheva D Shanes ◽  
Leena B Mithal ◽  
Sebastian Otero ◽  
Hooman A Azad ◽  
Emily S Miller ◽  
...  
Keyword(s):  
Perinatal Outcomes ◽  
Third Trimester ◽  
Fetal Demise ◽  
Intrauterine Fetal Demise ◽  
History Of ◽  
Retroplacental Hematoma ◽  
Adverse Perinatal Outcomes ◽  
Acute And Chronic Inflammation ◽  
Histopathologic Findings ◽  
Historical Controls

Objectives: To describe histopathologic findings in the placentas of women with COVID-19 during pregnancy. Methods: Pregnant women with COVID-19 delivering between March 18, 2020 and May 5, 2020 were identified. Placentas were examined and compared to historical controls and women with placental evaluation for a history of melanoma. Results: 16 placentas from patients with SARS-CoV-2 were examined (15 with live birth in the 3rd trimester 1 delivered in the 2nd trimester after intrauterine fetal demise). Compared to controls, third trimester placentas were significantly more likely to show at least one feature of maternal vascular malperfusion (MVM), including abnormal or injured maternal vessels, as well as delayed villous maturation, chorangiosis, and intervillous thrombi. Rates of acute and chronic inflammation were not increased. The placenta from the patient with intrauterine fetal demise showed villous edema and a retroplacental hematoma. Conclusions: Relative to controls, COVID-19 placentas show increased prevalence of features of maternal vascular malperfusion (MVM), a pattern of placental injury reflecting abnormalities in oxygenation within the intervillous space associated with adverse perinatal outcomes. Only 1 COVID-19 patient was hypertensive despite the association of MVM with hypertensive disorders and preeclampsia. These changes may reflect a systemic inflammatory or hypercoagulable state influencing placental physiology.

THIRD TRIMESTER INTRAUTERINE FETAL DEMISE AND THROMBOELASTOGRAPHY

1999 ◽  
Vol 88 (Supplement) ◽  
pp. 251S
Author(s):  
R.Y. Gershon ◽  
A.S. Alleyne ◽  
K.M. Mims
Keyword(s):  
Third Trimester ◽  
Fetal Demise ◽  
Intrauterine Fetal Demise

scholarly journals Placental Pathology in COVID-19

2020 ◽  
Vol 154 (1) ◽  
pp. 23-32 ◽  
Author(s):  
Elisheva D Shanes ◽  
Leena B Mithal ◽  
Sebastian Otero ◽  
Hooman A Azad ◽  
Emily S Miller ◽  
...  
Keyword(s):  
Perinatal Outcomes ◽  
Third Trimester ◽  
Fetal Demise ◽  
Intrauterine Fetal Demise ◽  
History Of ◽  
Retroplacental Hematoma ◽  
Adverse Perinatal Outcomes ◽  
Acute And Chronic Inflammation ◽  
Histopathologic Findings ◽  
Historical Controls

Abstract Objectives To describe histopathologic findings in the placentas of women with coronavirus disease 2019 (COVID-19) during pregnancy. Methods Pregnant women with COVID-19 delivering between March 18, 2020, and May 5, 2020, were identified. Placentas were examined and compared to historical controls and women with placental evaluation for a history of melanoma. Results Sixteen placentas from patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were examined (15 with live birth in the third trimester, 1 delivered in the second trimester after intrauterine fetal demise). Compared to controls, third trimester placentas were significantly more likely to show at least one feature of maternal vascular malperfusion (MVM), particularly abnormal or injured maternal vessels, and intervillous thrombi. Rates of acute and chronic inflammation were not increased. The placenta from the patient with intrauterine fetal demise showed villous edema and a retroplacental hematoma. Conclusions Relative to controls, COVID-19 placentas show increased prevalence of decidual arteriopathy and other features of MVM, a pattern of placental injury reflecting abnormalities in oxygenation within the intervillous space associated with adverse perinatal outcomes. Only 1 COVID-19 patient was hypertensive despite the association of MVM with hypertensive disorders and preeclampsia. These changes may reflect a systemic inflammatory or hypercoagulable state influencing placental physiology.

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