Intrauterine death most likely results in?
Ans. A. Hypofibrinogenemia. (Ref Textbook of Obstetrics D.C. Dutta 6th Ed.344f 345)Abruption placentae is the most common cause of severe consumptive coagulopathy in obstetrics.However, Slow development of maternal hypofibrinogenemia is most important complication of IUD.Intrauterine Death (IUD)Causes of recurrent intrauterine foetal death:DM, Rh incompatibility, Syphilis, Chronic nephritis, Antiphospholipid antibody syndrome, Idiopathic placental in sufficiencyClinical features:a) Absent foetal heart sound, no foetal movements, no quickening and decreased abdominal girth and uterine size.b) "Eggshell Crackling" of foetal head is pathognomonic.c) X-ray features--hyperflexion of spine and hyperextension of neck.# Crowding of ribs.# Spalding's sign: usually appear 7 days after death, also found in extra uterine pregnancy with live foetus.# Robert's sign (gas in heart and great vessels) appears as early as 12 hour of death. It is the reliable sign of IUD.Management:a) In 80% of cases spontaneous expulsion of foetus occur within two weeks of death.b) However nowadays early termination is favoured.c) Indications for LSCS in IUD are:# Major degree placenta previae.# Previous two ore more LSCS.# Transverse lie.
Hypofibrinogenemia
Cervical tear
Sterility
All of the above
Miscellaneous (Gynae)