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Re: any clues? From: Dr. Amarnath Bhide/Rajendra Deshpande (amarnath@bom2.vsnl.net.in) Fri Jul 11 11:43:48 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: rbraun@indyunix.iupui.edu: "Re: any clues?" Previous message: rbraun@indyunix.iupui.edu: "Re: GBS in non-pregnant situations" In reply to: Jose C. Ferreira: "Re: any clues?" Next in thread: dahmd: "Re: any clues?" On Thu, 10 Jul 1997, Jose C. Ferreira wrote: > > >Dr. Amarnath Bhide/Rajendra Deshpande wrote: > > >> > > >> A 22 yr old G1 registered for AN care at 16 weeks. 19 weeks scan was > > >> normal. No risk factors. A visit at 23 weeks, I was unable to document > FHS > > >> on stethoscope/doppler. No symptoms. An urgent USG documented severe > > >> oligoamnios and IUFD. > > > > > >I usually evaluate these patients with a fetal autopsy and karyotype > > >(sounds impossible in your situation with a macerated fetus), > > >antiphospholipid antibodies, a hysterosalpingogram (HSG) to rule out > > >uterine anomalies, and perhaps a hemoglobin A1C. Since the 19 week scan > > >was "normal" it sounds unlikely that a condition such as Potter's > > >Syndrome was the culprit, although another anomaly, including a > > >chromosomal problem, could have caused this. Good luck. I really hate > > >when tragedies like this happen. > > > > I agree with Ashley's assessment. My money (little that there is after > > managed care) is on fetal autopsy/karyotype findings being the culprit. > > > > -- > > Harvey > > Unfortunately, doing all that research, plus placental pathology (it's very > important to have someone with experience and knowledge in this field; > unfortunately there are not many) and viral and bacteriologic studies in > the mother and the fetus (placenta or amniotic fluid by amniocentesis > before delivery), one is able to find a cause in only about 40 to 50% of > cases. Our ignorance about the causes of fetal death is so big .....! Antiphospholipid screen was ordered and found normal. (ACL, APTT, LA etc.) I have not done an Hb A1C though FBS and 2 hrs post 100 gm glucose levels were normal. Dr. A. G. Bhide, MD Next message: rbraun@indyunix.iupui.edu: "Re: any clues?" Previous message: rbraun@indyunix.iupui.edu: "Re: GBS in non-pregnant situations" In reply to: Jose C. Ferreira: "Re: any clues?" Next in thread: dahmd: "Re: any clues?"

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