TEALE FENNING

Abik

Just sectioned a beby at 35+ weeks with a nasty sinusoidal CTG. Babe's Hb is 6.8!!

I am now wondering why.
Dad is black African and there was no abruption / vasa praevia.
??
Parvo virus
ABO incompatibility
Rhesus/ other antibodies
thalassaemia?
severe infection - GBS?

wolverine · Century Club Joined: 16 Jan 2007 Posts: 394

Really? So you have fun over there!
How did she present? It could be a massive feto-maternal haemorrhage.
Infection is also a cause of fetal anaemia. Parvo, toxo, CMV(?)
Rhesus issoimunization also.
Beta Thalassaemia and sickle cell don't present with intrauterine anaemia as they can produce HbF (2 a and 2 gamma chains) but A thalasaemia does.
What's the babies Plt? Direct Coombs?
Did you do a scan before the caesarean? Was it hydropic?
Does Lupus cause anaemia? Or just Thrombocytopenia?
Other infections? Malaria? Syphilis?

How interesting!

Abik · Posted: Sun Feb 25, 2007 6:47 pm Post subject:

blimey - bubbles all over the floor!!

There was no hydrops but no we didn't scan her first. The CTG was too bad. I forgot about foetal haemoglobin. I think it's probably infection. She had GBS - but no SRM and no maternal temp.
She came in last night with contractions and 1cm dilated. CTG was normal and she settled to sleep. Contractions continued but mild and the MW put her on the monitor this morning -- aargh!
Very exciting! (ish)

rpwalavalkar · Teale Fenning Administrator Joined: 20 Jul 2006 Posts: 973

dear abi and vangelis,

i have moved this thread to the open forum as it's more of discussion rather than 'key facts'. i hope you guys don't mind.

hope you both have had a good weekend. mine was great at the essay practice.

spk to you two soon.

tc
r
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Dr Miss. Raj Walavalkar MBBS MRCOG
TealeFenning Administrator
SR O&G Wessex Region

Nick Raine-Fenning · Posted: Mon Feb 26, 2007 6:46 pm Post subject:

Hey my new administrator is throwing her weight around already!! Laughing

I agree with her that this is a better place for such a discussion and when we have a formal final appraisal (if that ever happens Wink

) we can use the info in the Key Facts in O&G Forum.

What about vasa praevia? That would have been one of my first thoughts. Were her membranes intact? As wolverine said a Coomb's from cord and neonatal blood would be very interesting. If this is negative and the history is not compatible with vasa praevia then I guess infection is likely.
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