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 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.

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.

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.

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.

Florid Bacillus cereus Infection of the Placenta Associated With Intrauterine Fetal Demise

2021 ◽  
pp. 109352662199902
Author(s):  
Stephanie Shea ◽  
Alberto Paniz-Mondolfi ◽  
Emilia Sordillo ◽  
Michael Nowak ◽  
Fumiko Dekio
Keyword(s):  
Bacillus Cereus ◽  
Placental Tissue ◽  
Maternal Blood ◽  
Gastrointestinal Infections ◽  
Gram Positive ◽  
Fetal Demise ◽  
Placental Infection ◽  
Intrauterine Fetal Demise ◽  
Acute Necrotizing ◽  
Poor Outcomes

Bacillus cereus is a gram-positive, rod-shaped bacterium that is commonly implicated in foodborne illness but has also become increasingly recognized as a source of serious non-gastrointestinal infections, including sepsis, meningitis, and pneumonia. Non-gastrointestinal B. cereus infections have been identified in children, especially in neonates; however, there are no previously described cases of fetal demise associated with B. cereus placental infection. We present a case of acute chorioamnionitis-related intrauterine fetal demise of twin A at 17 weeks gestation, noted two days after selective termination of twin B. Histological examination revealed numerous gram-positive bacilli in placental tissue, as well as fetal vasculature, in the setting of severe acute necrotizing chorioamnionitis and subchorionitis, intervillous abscesses, acute villitis, and peripheral acute funisitis. Cultures of maternal blood and placental tissue both yielded growth of B. cereus. This case underscores the importance of B. cereus as a human pathogen, and specifically demonstrates its potential as an agent of severe intraamniotic and placental infection with poor outcomes for the fetus.

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