Cases reported "Fetal Death"

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1/33. Lymphoproliferative disorder of fetal origin presenting as oligohydramnios.

    lymphoma involving the placenta or fetus remains a very rare event. All cases reported to date have shown the lymphoma cells to be of maternal origin in that the tumor cells have preferentially involved the intervillous spaces with sparing of the villi and fetal circulation. We report a novel case of a monoclonal primary placental Epstein-Barr virus (EBV)-associated B-cell lymphoma of fetal origin. The placenta of a 20-week stillborn fetus born to a 19-year-old gravida 1 para 0 woman, presenting with oligohydramnios, showed a large cell infiltrate confined within villi and sparing the intervillous spaces, indicative of preferential involvement of the fetal circulation. Necropsy did not show any other site of involvement by malignant lymphoma or other abnormalities. Immunophenotypic studies showed the tumor cells to be of B-cell phenotype with a relatively high proliferation rate. EBV EBER1 RNA was identified in more than 95% of tumor cells, and polymerase chain reaction studies showed EBV EBNA1 strain type A and wildtype EBV LMP1. Analysis of the immunoglobulin heavy chain by polymerase chain reaction showed a monoclonal B-cell population. in situ hybridization studies using a commercially available probe directed at repeated sequences on the human y chromosome showed a single intense signal within trophoblastic epithelium and lymphoma cells, indicative of male origin. The mother remains in good health 11 months after delivery.
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ranking = 1
keywords = virus
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2/33. Fetal brain infection with human parvovirus B19.

    Intrauterine parvovirus B19 infection is known to be one of the causes of hydrops fetalis. However, there are few reports of the pathologic changes in the central nervous system. Postmortem examination of a fetus revealed multinucleated giant cells of macrophage/microglia lineage and many small calcifications around the vessels, predominantly in the cerebral white matter. parvovirus B19 genome dna was detected in the nucleus of the multinucleated giant cells and solitary endothelial cells by polymerase chain reaction amplification and in situ polymerase chain reaction methods. capsid antigen was also demonstrated in the cytoplasm of the endothelial cells by immunofluorescent assay. Thus, intrauterine B19 parvovirus infection could be associated with marked neuropathologic changes in the fetal brain at the midembryonal period. Neurologic follow-up of complications may be necessary for children who survive the intrauterine infection.
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ranking = 7
keywords = virus
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3/33. parvovirus B19 caused fetal death: a case report in thailand.

    This was a case of an intrauterine parvoviral B19 infection resulting in hydrops fetalis and enlarged placenta. Histologically, the virus was found to be in nucleated red cells of the fetus which was confirmed by electron microscopy. Careful placental examination at the gross and microscopic levels yielded the correct diagnosis.
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ranking = 5
keywords = virus
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4/33. Severe congenital cytomegalovirus infection with fetal hydrops in a cytomegalovirus-seropositive healthy woman.

    We report the case of a woman whose two consecutive pregnancies resulted in intrauterine fetal death due to severe congenital cytomegalovirus infection. In both pregnancies, congenital cytomegalovirus infection was prenatally diagnosed on the basis of detection of cytomegalovirus dna and specific IgM in cord blood. This case suggests that severe congenital cytomegalovirus infection can occur even in seropositive healthy women.
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ranking = 12
keywords = virus
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5/33. measles virus infection in the placenta of monozygotic twins.

    We report a case of monozygotic twins whose mother was infected with measles at 19 weeks' gestation. One of the twins died in utero at 32 weeks' gestation. The placenta of the stillbirth showed massive fibrin deposition, and some residual trophoblasts contained many inclusion bodies positive for measles virus antigen. Fetal organs and cells other than a few splenic lymphocytes showed no evidence of measles virus infection. The placenta of the surviving infant showed focal intervillous fibrin deposits, and only a few syncytiotrophoblasts were positive for measles virus antigen. At present, 7 months after the delivery, the surviving infant has not developed any sign of measles virus infection. Postpartum course of the mother has been uneventful, although high titers of serum anti-measles virus IgM persisted for 6 months after delivery. This case is informative in the following respects: the villous trophoblasts had diagnostic inclusion bodies and ultrastructural evidence of measles virus infection, the degree of viral involvement within the monochorionic placenta was uneven, both of the twins were virtually free from measles virus infection despite the marked involvement of the placenta, and measles virus infection had persisted in the monochorionic placenta for approximately 13 weeks.
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ranking = 8322.2824613821
keywords = measles virus, measles, virus
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6/33. hydrops fetalis secondary to parvovirus B19 infections.

    BACKGROUND: Fetal infection by human parvovirus B19 is a common cause of fetal anemia, nonimmune hydrops fetalis, and spontaneous abortion and can result in fetal death. Recent improvements in diagnosing parvovirus infections and the availability of intrauterine transfusion have reduced the overall rate of fetal loss after maternal exposure. methods: We report two cases of maternal parvovirus infection with classic findings of hydrops fetalis and review various aspects of parvovirus infection with emphasis on the developing management options in pregnancy. RESULTS AND CONCLUSIONS: Different management led to different results. In the first case there was normal neonatal and infantile development, and in the second case, the fetus died. With accurate laboratory testing, obstetric sonography, and fetal transfusion, the fetal mortality from parvovirus infection has been reduced considerably, and most pregnancies complicated by maternal parvovirus infection result in healthy outcomes.
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ranking = 10
keywords = virus
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7/33. Congenital cytomegalovirus infection after recurrent infection: case reports and review of the literature.

    cytomegalovirus (CMV) is one of the most common causes of congenital infections in developed countries with reported incidences varying between 0.15% and 2.0%. The effects of congenital CMV infection may vary from a congenital syndrome to an asymptomatic course. Infants that are asymptomatic at birth may still present handicaps at a later age. It is generally accepted that symptoms of congenitally infected children are more severe after primary infection than after recurrent infection. In this article, we present two case reports which demonstrate that the outcome of recurrent maternal CMV infection may be severe. In the first case, early pregnancy serology showed positive IgG and IgM, but negative IgA, whereas at the time of diagnosed fetal death, 5 weeks later, there was only positive IgG. The second case showed positive IgG and negative IgM and IgA both in early pregnancy and after delivery. Since in both cases CMV was isolated from several organs, these findings are compatible with recurrent rather than primary CMV infection. In the reported patients, fetal death and necrotising enterocolitis occurred after a congenital CMV infection, with mothers having pre-existing immunity to CMV. In conclusion, these case reports and review of the literature emphasise that the outcome of recurrent maternal CMV infection may be severe and that congenital CMV infection should be considered in cases of pregnancy loss and necrotising enterocolitis with recurrent maternal CMV infection.
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ranking = 5
keywords = virus
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8/33. Measles infection in pregnancy.

    OBJECTIVES: Measles during pregnancy has deleterious effects on both the perinatal outcome and the mother. However, in-depth knowledge about gestational measles is lacking. The objectives of this study were to describe the clinical course of eight cases of gestational measles and to study the effect of measles and pregnancy on each other. methods: From late 2000 to early 2001, we experienced a measles outbreak with eight infected pregnant women. The clinical course of each case is described in detail. RESULT: Three of the four cases before 24 weeks of gestation ended in spontaneous abortion or stillbirth. The clinical course of the three abortions and stillbirth were singular because of the sudden onset of the abortion and the spontaneous pregnancy termination. In contrast, the four pregnancies after 25 weeks of gestation ended in live-term delivery and two out of the four neonates were diagnosed with congenital measles. There was no maternal death, instead two pneumonia cases and one hemorrhagic shock case. CONCLUSIONS: Gestational measles may potentially damage the fetus and is one of the serious complications that can occur during pregnancy.
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ranking = 94.671643185289
keywords = measles
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9/33. hemorrhagic fever with renal syndrome presenting with intrauterine fetal death. A case report.

    BACKGROUND: Hantavirus infection in pregnancy is rare. Only 2 cases of hantavirus pulmonary syndrome have been reported in the English-language literature. We report a case of hemorrhagic fever with renal syndrome (HFRS) complicating pregnancy to alert clinicians to this rare possibility. CASE: A 29-year-old woman had experienced persistent, high fever for 6 days, no fetal movement for 2 days and frequent vomiting for 1 day before being referred to our department with the additional symptoms of headache, lumbodynia and orbital pain. On examination, she had a normal body temperature, flushing of the face, conjunctive congestion, pharyngeal congestion, bulbar conjunctive edema, severe jaundice, petechiae and ecchymosis at sites of venipuncture, deranged liver and renal function tests, heavy proteinuria and hematuria, and coagulation disturbance. The diagnosis of HFRS complicating pregnancy was made on account of the clinical picture and antihantavirus IgM titer of 1:20. The patient's condition quickly deteriorated, with frank hematuria, oliguria and finally anuria, together with shock. Hemodialysis was immediately commenced, and a stillborn, male infant, of 3,200 g, was delivered vaginally following combined induction 12 hours after hemodialysis. The fetus showed no obvious abnormalities, but the parents declined an autopsy. After hemodialysis and delivery, the patient recovered and was discharged 3 weeks later. The repeat titer for antihantavirus IgM was 1:80 10 days after presentation. CONCLUSION: HFRS is a rare complication of pregnancy. The symptoms are nonspecific. early diagnosis and appropriate management are necessary to improve the maternal and fetal outcome. Clinicians should include this condition in the differential diagnoses when a combination of hematologic, hepatic, renal and gastrointestinal problems presents in pregnancy.
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ranking = 4
keywords = virus
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10/33. Intrauterine fetal death due to echovirus 11.

    In a case of intrauterine fetal death in the 29th week of gestation, echovirus 11 could be isolated from the umbilical cord of the fetus. The mother had no apparent signs of infection but serological evidence of current echovirus 11 infection. enterovirus PCR performed on paraffin-embedded specimens of various tissues (myocardium, lung, liver and placenta) from the fetus yielded positive results in all cases. These findings, together with supporting serological and epidemiological findings--e.g. proven echovirus 11 infection 3 weeks before in the 18-month-old son of the woman--constituted strong evidence that echovirus 11 infection was responsible for the fetal death.
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ranking = 9
keywords = virus
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