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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Patient Pregnant With Sudden IUD, Early Labor, Absent FHR, Delivers Macerated Fetus. Patient Negligence?

Ig M all negative, Cyto ig g 169


primigravida, 39+5 weeks pregnancy, uncomplicated pregnancy presents with sudden iud ? where did something go wrong ?patient seen on 6th April, good fetal movements, comes on 8th with early labor and FHR absent ? delivers a macerated fetus weighing 3.25 kg, thick MSL, no cord around neck/no abruptio, . could this IUD be prevented ? pts blood sugars, T3,T4,TSH all normal . no h/o high BP,then what went wrong ? was it negligence on patients part that she did not report loss of movement ?
posted on Mon, 15 Apr 2013
Twitter Sun, 12 May 2013 Answered on
Twitter Mon, 13 May 2013 Last reviewed on
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OBGYN,  's  Response
Sometimes such extreme unfortunate things happen without any clue. Diabetes, autoimmune diseases, thyroid abnormalities, intrauterine infections, trauma, cord accidents, all are associated with such incidents. Also we don't know if the baby had some congenital anomalies. Still unexplained IUD is a reality.
But one thing strike me. A baby with good movements (?? didn't someone check the FH then?) getting macerated in 48 hrs is quite unlikely. This might be a clue for your investigation.
In this kind of situations,never put the blame on the subject (patient). It is gross. Fetal movement is such an unreliable indicator that almost every women claim to have it till hours or minutes before the diagnosis of IUD.
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Patient Pregnant With Sudden IUD, Early Labor, Absent FHR, Delivers Macerated Fetus. Patient Negligence?

Sometimes such extreme unfortunate things happen without any clue. Diabetes, autoimmune diseases, thyroid abnormalities, intrauterine infections, trauma, cord accidents, all are associated with such incidents. Also we don t know if the baby had some congenital anomalies. Still unexplained IUD is a reality. But one thing strike me. A baby with good movements (?? didn t someone check the FH then?) getting macerated in 48 hrs is quite unlikely. This might be a clue for your investigation. In this kind of situations,never put the blame on the subject (patient). It is gross. Fetal movement is such an unreliable indicator that almost every women claim to have it till hours or minutes before the diagnosis of IUD.