Question

caridad is a 26 year old, G1PO, at 28 wga. Her pregnancy so far has been uneventful expect for some spotting during the first six weeks. Caridad smokes 3 to 4 cigarettes a day.

Case study

Caridad calls the prenatal clinic to say that earlier this morning she had felt her baby move a lot. she said the movement was so violent that it actually hurt her. Now she realizes that she has not felt her baby move again all day. She is told to come in, and the baby's heart tones are checked. They cannot be located. An ultrasound is ordered, and the diagnosis of fatal demise is made.

Questions

Is there a relationship between the spotting during the first trimester and later intrauterine fetal death (IUFD)?

Caridad is not experiencing any bleeding or cramping at this time. what is the probability hat she will go into spontaneous labor soon?

if she does not go into labor, how will the pregnancy be terminated?

what are the risk for Caridad if she decides to wait for her body to naturally go into labor

Answer 1

Though it's undeniable that bleeding or spotting in the first trimester may mean an impending miscarriage (a type of pregnancy loss), it can signal other issues too. About half of women who have first-trimester vaginal bleeding have a miscarriage.

In the case of fetal demise, a dead fetus that has been in the uterus for 4 weeks can cause changes in the body's clotting system. These changes can put a woman at a much higher chance of significant bleeding if she waits for a long time after the fetal demise to deliver the pregnancy.

The rate of spontaneous onset of labour in women whose pregnancies remain uncomplicated between 41+0 and 42+0 weeks is 67%. Approximately 10% of women had a medical indication for delivery, either by induction of labour or pre-labour Caesarean section.

induction abortion involves medications that cause the uterus tocontract and expel the pregnancy. After a certain point in pregnancy (usually around 24 weeks), a dilation and evacuation (D&E) procedure can no longer be performed and the only option is an induction abortion.

Problems at birth due to smoking during pregnancy include increased risk of premature birth. increased risk of miscarriage and infant death. lower birth weight – on average, about 150 to 200 grams less than normal. up to three times the risk of sudden unexpected death in infancy (SUDI).