[Case of intrauterine retardation and fetal death during labor]. 2014

B Frundeva, and V Dimitrova, and A Museva, and A Dimitrov, and V Zlatkov

The case concerns to a 37 years old pregnant woman with a history of three miscarriages. Ultrasound biometry in early pregnancy corresponds to the term calculated according the last menstrual period (LMP). At 37 week of gestation was determined retardation of 5 weeks. Doppler velocimetry and quantity of amniotic fluid were in normal ranges and the pregnant refused hospitalization. She was admitted to the hospital three days after the appointed term without uterine contractions. The fetal ultrasound biometry meets 33 weeks and the Doppler examination of a. umbilicalis found resistance index (RI) of the upper limit of normal. The cardiotocography record shows: baseline fetal heart rate--143 beats/min, good variability and reactivity. There was one deceleration for 3 minutes, and then the recording returns to normal. Re-monitoring after 30 minutes establishes of a periodic decelerations and a tendency to bradycardia with reserved variability. At the start of the emergency Cesarean Section fetal heart beats are single. The delivered babe was with Apgar O. The reanimation was not successful and the fetus died. From the autopsy signs of severe asphyxia. In conclusion, it can be assumed that in strongly retarded fetuses, cardiotocography recording and Doppler velosimetry are not sufficiently reliable methods for continued monitoring. In late-onset and severe intrauterine growth retardation (IUGR) desirable delivery time is after reaching biological maturity at 36-37 week.

UI MeSH Term Description Entries
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D002585 Cesarean Section Extraction of the FETUS by means of abdominal HYSTEROTOMY. Abdominal Delivery,Delivery, Abdominal,C-Section (OB),Caesarean Section,Postcesarean Section,Abdominal Deliveries,C Section (OB),C-Sections (OB),Caesarean Sections,Cesarean Sections,Deliveries, Abdominal
D005260 Female Females
D005313 Fetal Death Death of the developing young in utero. BIRTH of a dead FETUS is STILLBIRTH. Fetal Mummification,Fetal Demise,Death, Fetal,Deaths, Fetal,Demise, Fetal,Fetal Deaths,Mummification, Fetal
D005317 Fetal Growth Retardation Failure of a FETUS to attain expected GROWTH. Growth Retardation, Intrauterine,Intrauterine Growth Retardation,Fetal Growth Restriction,Intrauterine Growth Restriction
D005323 Fetal Monitoring Physiologic or biochemical monitoring of the fetus. It is usually done during LABOR, OBSTETRIC and may be performed in conjunction with the monitoring of uterine activity. It may also be performed prenatally as when the mother is undergoing surgery. Monitoring, Fetal,Fetal Monitorings,Monitorings, Fetal
D006340 Heart Rate, Fetal The heart rate of the FETUS. The normal range at term is between 120 and 160 beats per minute. Fetal Heart Rate,Fetal Heart Rates,Heart Rates, Fetal,Rate, Fetal Heart,Rates, Fetal Heart
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000026 Abortion, Habitual Three or more consecutive spontaneous abortions. Abortion, Recurrent,Miscarriage, Recurrent,Recurrent Early Pregnancy Loss,Habitual Abortion,Habitual Abortions,Recurrent Abortion,Recurrent Abortions,Recurrent Miscarriage,Recurrent Miscarriages
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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