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Labor induction in fetal death and placenta praevia (3)From: Marinus van der Ploeg, MD (jmvanderploeg@hotmail.com)Tue Feb 29 01:12:20 2000
----------------------------------------------------------- G3P2. Twice normal pregnancy's and normal vaginal delivery. Now ----------------------------------------------------------- intrauterine fetal death at 23+1 weeks of pregnancy with a placenta ----------------------------------------------------------- praevia totalis. ----------------------------------------------------------- Dear colleagues, ----------------------------------------------------------- ----------------------------------------------------------- In January there has been an interesting (they all are)thread in reaction to a case presented by me (see above). Most of you will for sure remember it. Two weeks after we diagnosed the fetal death (25+1 weeks amenorrhea), she went spontaneously into labor. We didn't treat her with MTX. At that time she had a normal coagulation status. First she gave birth to the placenta in the delivery room. Also one fetal arm came spontaneously. Because of further stagnation in labor, the rest of the fetus was easily extracted by hand in the operation room under general analgesia. Finally a blunt curettage showed only some rest 'decidua'. Total blood: approximately 100 cc! The placenta weighed 100 gram and was 10x6x2 cm. It showed an old retroplacentair haematoma and almost 75% of the underlying placenta parenchyma showed infarction. Most probably this process has been the cause of death. No congenital disorders could be found in the third degree macerated fetus of 470 gram. With other words: medically an easy uncomplicated delivery. Thanks to nature, again. I'm still interested in any comments. Thanks again and great forum! Marinus
-- Marinus van der Ploeg, MD Assistant Physician Obstetrics and Gynaecology Apeldoorn, the Netherlands jmvanderploeg@hotmail.com t. +31 (0)55 581 81 81 (*31 531)
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