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Antineoplastic Drugs during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Among seven women treated from conception to delivery, one stillborn premature infant and one fetal death occurred (Koh et al., 2002; Koh and Kanagalingam, 2006). Five apparently normal infants were born after exposure to hydroxyurea throughout gestation.
Principles of lung surgery
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Saleem Islam, James D. Geiger, Steven S. Rothenberg, M. Kunisaki Shaun
Congenital pulmonary airway malformations (CPAMs, previously known as congenital cystic adenomatoid malformations (CCAMs)) are lesions that are mostly diagnosed with prenatal ultrasound. They form 25% of all congenital lung malformations but are still rare. Some become large enough that they cause lung hypoplasia and can also impede caval blood return, thus causing polyhydramnios and hydrops fetalis. Some of the affected fetuses will be stillborn. In selected centers, fetal thoracotomy and lung resection are performed in those who develop hydrops, with resultant improved survival. CPAMs are found in the left lower lobe in 25%, left upper lobe in 20%, right lower lobe in 19%, and right upper lobe in 10%.
Bereavement – dealing with the loss of a baby
Published in Alison Edwards, Postnatal and Neonatal Midwifery Skills, 2020
Unfortunately, babies continue to be stillborn, die in utero or die within days of the birth. It proves to be an extremely difficult time for the families but also for the staff involved. There are, however, a number of activities that need to be undertaken. Some of these may help with the emotional distress.
Intrauterine Fetal Demise Associated with Vascular Malperfusion and Multiple Uterine Leiomyomata: A Report of Two Cases
Published in Fetal and Pediatric Pathology, 2023
Tess E. K. Cersonsky, Megan Lord, Halit Pinar
A 34-year-old G2P0010 with a history of one prior spontaneous first trimester miscarriage and anemia was found to have multiple uterine leiomyomata on ultrasound at 12 weeks 3 days GA; alongside a fetus with crown-rump length (CRL) of 5.8 cm, appropriate for GA, a fundal leiomyoma measuring 3.9 × 3.6 × 4.4 cm, two posterior leiomyomata measuring 2.5 × 2.0 × 2.5 cm and 3.4 × 3.2 × 3.6 cm, and many smaller leiomyomata were observed (Fig. 1b). No abnormalities were observed at 20 week fetal anatomic survey. The patient noted an absence of fetal movement at approximately 25 weeks 4 days GA; no fetal cardiac activity was appreciated on ultrasound. Minimal amniotic fluid was noted, with amniotic fluid index of 2.3 cm. The patient was admitted for induction of labor and delivered a stillborn fetus and placenta without complication.
Value of Placental Examination in the Diagnostic Evaluation of Stillbirth
Published in Fetal and Pediatric Pathology, 2022
The definition of stillbirth varies between countries depending on the used viability threshold. World Health Organization defines stillbirth as the fetal death that occurs at 22 weeks gestation (WG) or later or the birth of a stillborn that weighs at least 500 g. However, the French National College of Gynecologists and Obstetricians (FNCGO) proposed a standardized definition for stillbirth including all fetal deaths occuring after 14 WG [1]. The use of this threshold is justified by the need to determine not only the cause of death of viable fetuses, but also the cause of stillbirth that prevents fetal viability. Indeed, before 14 WG, the most common cause of miscarriage is chromosomal aberration [2]. After 14 WG, etiology especially involves placental and maternofetal disorders, some of which may be prevented or treated. As a result, the management and etiologic evaluation are different.
Factors contributing to late stillbirth among women with pregnancy hypertension in a developing country
Published in Hypertension in Pregnancy, 2020
Manisha Kumar, Ravi Vajala, PhunstokDoma Bhutia, Abha Singh
This cross-sectional, observational study was done after ethical clearance at a single tertiary care center, as a part of the WHO SEARO project. The project began in August 2015 and is continuing at present. All patients who presented to our institution with late stillbirth during the study period, August 2015 to February 2019 were included in the study. All babies delivered after 20 weeks of gestation showing no sign of life after birth were considered stillborn. The period of gestation was calculated according to the last menstrual period (LMP) or first-trimester ultrasound if it was not known. The relevant conditions found were classified under the CODAC system of stillbirth classification. Associated conditions like anemia, small for gestational age were also looked into. Late stillbirth was taken as stillbirth occurring at or after 28 weeks of gestation. Hypertensive disorder of pregnancy (HDP) was taken as any rise of blood pressure 140/90 mm Hg on 2 occasions 4 hours apart. Preeclampsia was defined according to ACOG 2013 guidelines (9). Early-onset hypertension was termed as those which occurred before 34 weeks of gestation. Small for gestational age (SGA) was considered when the birth weight was less than the tenth centile for the gestational age according to the intergrowth 21 chart (10). Hemoglobin of less than 11 gm/dl was contemplated as anemia. The BW/PW ratio cutoff was taken as <8 with reference to study by Bukowsky et al. in which the ratio was reported as 7.7 (11).