American journal of perinatology
-
Appropriate length of delivery room resuscitative efforts for infants born without signs of life is controversial. We present the case of a preterm infant with Apgar scores of 0 at 1, 5, and 10 minutes but with a recovered heartbeat at 15 minutes. Using the clinically relevant conceptions of the principle of futility, we examine the ethical justification for the successive decisions to initiate, continue, and ultimately limit care for this patient. This difficult case highlights the importance of understanding the ethical justification for clinical interventions that are made in the neonatal intensive care unit.
-
Limited information is published on the frequency of new maternal alloantibodies found in patients treated for isoimmunization. The purpose of this study was to determine the prevalence of additional maternal red cell alloantibodies, found after the initiation of treatment for Rhesus (Rh) disease. A retrospective review of all patients treated for severe Rh disease was undertaken. ⋯ Seven patients (23%) were found to develop additional red cell alloantibodies after treatment during the pregnancy. Induction of additional maternal red cell alloantibodies after treatment for severe Rh disease is relatively common. This may have significant implications for future pregnancies in this high-risk population.
-
Preeclampsia is uncommon prior to 24 weeks gestation and has been associated with partial and complete hydatidiform moles. We present an unusual case in which a patient was diagnosed with preeclampsia at 17 weeks gestation. Ultrasound findings were consistent with a partial hydatidiform mole. ⋯ Termination of pregnancy was performed with rapid resolution of signs, symptoms, and laboratory abnormalities. Triploid 69,XXY was confirmed at karyotype analysis. This case demonstrates the acuteness in which life-threatening maternal conditions can arise with this uncommon complication of pregnancy, and the importance of correct identification of the characteristic ultrasonographic findings associated with a partial hydatidiform mole.