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medicalmeds.eu Obstetrics Pre-natal death of a fruit

Pre-natal death of a fruit


Description:


Pre-natal death of a fruit — death of a fruit during pregnancy (antenatal death) or at the time of delivery (intranatal death).


Symptoms Pre-natal death of a fruit:


Symptoms of pre-natal death of a fruit in the first half of pregnancy are the termination of growth of a uterus, discrepancy of its size to duration of gestation, reduction of a nagrubaniye of mammary glands. Sometimes there are an indisposition, feeling of fatigue, heavy feeling in a stomach. In the second half of pregnancy, in addition to the specified symptoms, disappearance of heartbeat and the movement of a fruit at ultrasonography is characteristic. At the time of delivery the termination of its heartbeat is a sign of death of a fruit.


Reasons Pre-natal death of a fruit:


Infectious diseases of the pregnant woman at which activators and toxins are transmitted through a placenta (for example, flu, a typhoid, sepsis), and the toxicoses of pregnant women (especially a nephropathy and an eclampsia) causing a fruit hypoxia are the main reasons for pre-natal death of a fruit. Can lead such diseases of the pregnant woman as dekompensirovanny heart disease, an idiopathic hypertensia, nephrite, anemia, hypovitaminoses, and also acute and chronic poisonings to pre-natal death of a fruit (for example, lead, phosphorus, mercury, alcohol), injuries. Quite often incompatibility of blood of mother and a fruit on a Rhesus factor, the AB0 system or other factors of blood is a cause of death of a fruit. Death of a fruit comes also at defects of its development, heavy, not compatible to life. At the time of delivery death of a fruit can happen owing to an acute hypoxia fruit in connection with premature placental detachment, umbilical cord encirclement around a neck, a true node of an umbilical cord, weakness of patrimonial activity, etc. Uterus diseases (for example, an endometritis, tumors), the wrong position of a uterus, placental presentation, a short or long umbilical cord, a hydramnion or an oligoamnios, a multiple pregnancy belong to the contributing factors.


Treatment Pre-natal death of a fruit:


At suspicion on pre-natal death of a fruit during pregnancy the woman needs to be sent to a hospital urgently. The diagnosis is based on data of ultrasonography and auscultation, an ECG of a fruit and cardiomonitor observation (lack of cordial complexes). Other methods: X-ray inspection of a fruit (characteristic changes of a skeleton of a fruit), results of determination of content of hormones in the pregnant woman's blood (decrease in concentration of estriol and progesterone) have auxiliary value. In a hospital at confirmation of the diagnosis carry out a rodovozbuzhdeniye with opening of a bag of waters, and to early durations of gestation (to 12 weeks) — tool removal of fetal egg. Because abortion and childbirth at pre-natal death of a fruit can be followed by the uterine bleeding caused by disturbance of coagulant system of blood it is necessary to be ready to transfusion of blood preparations, blood substitutes.

At not recognizable pre-natal death of a fruit it usually spontaneously is expelled from a cavity of the uterus as abortion (at duration of gestation to 28 weeks) or premature births (at term more than 28 weeks). The fruit which died and born after the 28th week of pregnancy is considered mortinatus. Exile of the died fruit usually comes from a cavity of the uterus soon after his death or later 2 — 3 weeks, is more rare in later terms. In case of a delay of the died fruit in a cavity of the uterus it is exposed to wet decomposition (maceration) or drying (mummification). Extremely seldom in fabric of the mummified fruit salts of calcium are laid and the fossilized fruit is formed. At penetration of contagiums perhaps putrefactive decomposition of the died fruit that in some cases leads to development of sepsis in the woman.




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