Image Based Question-66877

A pregnant woman suffering from Preeclampsia,with 30 weeks of pregnancy presented with a history of not able to perceive fetal movements,reduced breast size.

On USG examination,the following picture was seen.Identify this condition.

A. Abortion

B. Eclampsia

C. Intrauterine Death

D. Hydatidiform mole

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Correct Answer » C Explanation

Ans:C. Intrauterine Death.

Intrauterine death

• It is the term used when the death of a fetus occurs after the 20th week of pregnancy.

• Prior to this, it is considered a miscarriage.

Clinical Features:

• The mother may notice less movement in the fetus for several days, and her breasts may diminish in size.

• In cases of hypertension the blood pressure sometimes falls.

• The uterus may be found to be smaller than the duration of pregnancy

EtioPathology

Maternal

• gestational hypertension

• blood group incompatibility

• metabolic disorders

• intrauterine infections

Fetal

• major anomalies

• umbilical cord complications ( looping, knotting, twisting)

• Placental

• chronic placental insufficiency

• placental abruption

• chorioamnionitis

Radiographic features

Ultrasound

• absent fetal heart beat

• absent fetal movements

• overlapping of skull bones (Spalding sign)

• gross distortion of fetal anatomy (maceration)

• soft tissue oedema: skin >5 mm

• echogenic amniotic fluid (fetal demise fragments)

• thrombus in fetal heart

• gas shadow in fetal heart (Robert sign)