Naslov
Delivery course of macerated stillborn fetuses in the third trimester

Autori
Habek, Dubravko

Izvornik
Fetal diagnosis and therapy (1015-3837) 24 (2008), 1; 42-46

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
stillbirth, delivery, outcome

Sažetak
We present and discuss delivery (maternal and fetal) outcome of macerated stillbirths in the third trimester. In this retrospective observational study, the course of labor was analyzed in 10 stillborn fetuses with a varying grade of maceration during the third trimester. Medical documentation on the course of pregnancy, maternity ward history and histopathology was used to analyze maternal demography data, course of labor, fetal birth weight and birth length, fetal findings (grade of maceration, concomitant finding of cord accidents) and maternal peripartum outcome. Chronic cigarette smoking was recorded in 6, gestational hypertensive disease in 2, intrauterine growth retardation in 2 and abruptio placentae in 3 patients (in 2 of them due to gestational hypertensive disease). Six deliveries were induced by PGE(2) vaginal gel, 2 were stimulated by oxytocin and 1 was initiated spontaneously. One primary cesarean section was performed for evident fetopelvic disproportion. Outlet vacuum extraction for prolonged second labor stage was performed in the macrosomic child in the quadripara and 1 manual assistance according to Bracht was necessary at delivery of a macerated stillborn fetus due to breech presentation. In 1 case of macerated stillborn fetus, head traction resulted in decapitation, therefore extraction with Braun hooks placed into axillary fossae was done to extract the retained macerated fetal body. According to pathoanatomical evaluation, there were 2, 4, 3 and 1 stillbirths with grade 0, I, II and III maceration, respectively. Nuchal cord strangulation and tightened knot were detected in 3 cases each. In 2 cases of abruptio placentae, the parturients developed obstetric shock with uterine atony and disseminated intravascular coagulation. There was no maternal mortality and no fetal malformations in our material. The peripartum course can be considerably compromised due to potential complications induced by autolytic (macerating) lesions and difficult course of labor and maternal outcome.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA