Cases reported "Abruptio Placentae"

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1/15. Placental pathology casebook. Chorangiosis of the placenta increases the probability of perinatal mortality.

    Two apparent acute problems that may occur in labor, nuchal cord and placental abruption, were associated with chorangiosis of the placenta. The importance of complete placental examination in perinatal mortality is re-emphasized. The association of apparent acute obstetrical conditions, e.g., nuchal cord and placental abruption with chorangiosis of the placenta, may be the cause of fetal-newborn deaths that were previously assumed to be issues of labor management.
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ranking = 1
keywords = death
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2/15. fetal death from abruptio placentae associated with incorrect use of a seatbelt.

    A female driver, 24 weeks pregnant, was wearing a three-point seatbelt in the manner usual for nonpregnant women, when her automobile collided head-on with another vehicle. A cardiotocographic examination after the accident revealed the fetus to be alive. Five days after the accident, however, a cardiotocographic examination showed fetal death. At that time, a transverse ecchymotic band on the lower abdominal wall that had not been observed at the first examination was noticed. Eight days after the accident, the mother delivered a macerated female fetus. At autopsy, the baby showed no abnormality, but there was a hematoma on the placental surface toward the uterus. These results suggest that the fetus died of abruptio placentae associated with incorrect placement of the lap belt.
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ranking = 5
keywords = death
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3/15. Complications of third-trimester amniocentesis using continuous ultrasound guidance.

    OBJECTIVE: The objective of the study was to estimate the risks of third-trimester amniocentesis with continuous ultrasound guidance. methods: Cohort study. We reviewed the medical records of women who had an amniocentesis with continuous ultrasound guidance after 30 weeks' gestation at a single institution from January 1991 through December 1994. For procedures performed from January 1991 to February 1994, we obtained information from a chart review. From March 1994 to December 1994, we collected data prospectively. The primary outcome was whether or not there were any complications within 48 hours of the procedure. We also sought to determine any risk factors associated with complications. RESULTS: Complete records and data were available for 562 amniocenteses during the study period. The mean gestational age at the time of amniocentesis was 34.9 weeks. Of the 562 procedures, five (0.8%) were unsuccessful and 50 (9%) required more than one needle stick. The complication rate was 0.7% (95% confidence level (CI) = 0.02%, 1.9%). These included spontaneous labor in a preterm gestation (1), premature rupture of the membranes (1), placental abruption (1), and fetal-maternal hemorrhage (1). No patient required an emergency cesarean delivery and none suffered a perinatal death (95% CI 0, 0.8%). Complications were not associated with the number of needle sticks, the presence of bloody amniotic fluid, or the level of operator experience. CONCLUSIONS: Third-trimester amniocentesis performed with continuous ultrasound guidance has a high success rate and low risk for complications.
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ranking = 1
keywords = death
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4/15. Pulmonary embolization by chorionic villi causing maternal death after a car crash.

    Throughout the last century, there has been a marked decline in obstetric maternal deaths, resulting in an increase in the proportion of nonobstetric deaths among pregnant women. Trauma, in particular, has become a leading cause of maternal death. We report the case of a 20-year-old primigravid woman who was involved in a motor vehicle crash at 36 weeks gestation. The woman developed abruptio placentae, followed by disseminated intravascular coagulation, adult respiratory distress syndrome, and shock, and died the day after the crash. Widespread pulmonary embolization by chorionic villi was identified at autopsy. This report discusses traumatic maternal deaths, with emphasis on the differences in injury pattern observed in pregnant trauma victims in comparison with other adults. It is important that the pathologist be aware of these problems so that an accurate cause of death can be identified in cases of maternal death after trauma. Also discussed is the relationship between trauma and placental abruption and the mechanism of death in the patient. To the authors' knowledge, this is the first reported case of extensive embolism of chorionic villi to the lungs after trauma.
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ranking = 3738.5791541216
keywords = maternal death, death
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5/15. ritodrine therapy in the presence of chronic abruptio placentae.

    BACKGROUND: Betamimetic therapy is usually contraindicated for the treatment of premature labor associated with abruptio placentae. We report prolongation of a pregnancy for 7 weeks using ritodrine despite the presence of placental abruption. CASE: A 33-year-old primigravid woman presented at 25 weeks' gestation with irregular uterine contractions, vaginal bleeding, and sonographic evidence of abruptio placentae. Port wine-colored amniotic fluid was found during amniocentesis, and serial hematocrits decreased from 36 to 25%. A diagnosis of abruptio placentae was made, and because the maternal cardiovascular and fetal biophysical indices were normal, tocolytic therapy was started. Before the administration of ritodrine, the patient and her husband were given an extensive review of the risks, including blood transfusion, adult respiratory distress syndrome, disseminated intravascular coagulopathy, and maternal or fetal death. CONCLUSION: Although clinical suspicion of abruptio placentae remains a contraindication to betamimetic therapy, exceptions may be made if fetal and maternal well-being can be monitored and if a fully staffed operating room is always available for immediate cesarean delivery. The benefits of this management may outweigh the associated risks for carefully chosen, very preterm gestations.
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ranking = 1
keywords = death
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6/15. Abruptio placenta following sexual intercourse: case report.

    This is a case of Abruptio Placenta resulting from sexual intercourse. Pelvic Examination revealed active bleeding per vaginam. The pregnancy resulted into intra-uterine foetus death. The foetus membranes were ruptured and labour progressed. A still born male baby was delivered.
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ranking = 1
keywords = death
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7/15. abruptio placentae during fetal myelomeningocele repair.

    Myelomeningocele (MM) is a congenital neural tube defect with serious consequences, including hydrocephaly. An important hope for intrauterine repair is that hydrocephaly may be prevented by reversing the arnold-chiari malformation. Three medical centers in the united states are doing trials with this objective. We describe an intrauterine correction of MM in a Brazilian research center of fetal medicine, which resulted in abruptio placentae and fetal death, to illustrate factors that influence fetal-maternal risks during this surgical procedure.
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ranking = 1
keywords = death
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8/15. fetal death following maternal trauma: two case reports and a survey of the literature.

    When a fetus dies after its mother has suffered trauma, questions often arise about whether the fetal death was linked to the maternal injury. Many state statutes make it a criminal act to cause the death of a fetus by injuring the mother. The authors present two cases in which fetal death resulted from maternal trauma. In addition, we review the pertinent literature on this subject and offer guidelines that may help forensic pathologists evaluate these difficult and often emotionally charged cases.
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ranking = 7
keywords = death
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9/15. The use of Doppler umbilical artery waveforms in placental abruption; a report of two cases.

    In a prospective study, the predictive value of Doppler umbilical arterial velocimetry waveforms in detecting the fetus at risk was examined in ten patients with abruptio placenta. One patient suffered intra-uterine fetal death within 8 h of obtaining a normal reactive cardiotocograph and normal umibilical artery waveforms. In another patient with severe placental abruption, following 2500 ml of blood loss, the umbilical artery waveforms were normal. In this study, umbilical artery waveforms failed to predict fetal outcome in cases of placental abruption.
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ranking = 1
keywords = death
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10/15. Fetal survival following coagulopathy at 17 weeks' gestation.

    Placental separation in the third trimester of pregnancy may be associated with coagulopathy, fetal distress, or intrauterine death. We report a case of vaginal bleeding due to placental separation at 17 weeks' gestation associated with disseminated intravascular coagulation. After treatment with blood, fresh frozen plasma, and fibrinogen, the pregnancy progressed uneventfully for another 12 weeks, when delivery by emergency cesarean section was performed.
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ranking = 1
keywords = death
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