Pregnancy and Birth

When an adverse outcome and missed diagnosis occur, problems in the organization of care and issues with communication between caregivers are frequently the true cause rather than an isolated error made by one practitioner. In recent years, seeking to capitalize on frustration with the health care delivery, plaintiff’s lawyers have sought to identify disagreements among providers in patient management and/or errors within the patient care management system. Allegations that nonphysician personnel should have recognized a problem with the care plan and accessed the “chain of command” in an effort to alter the clinical course are included in these types of claims.

What are echogenic intracardiac foci (EIF)? EIF are small, echogenic lesions seen (on sonography) inside the left or right ventricles of the fetal heart within the papillary muscles or chordae tendinae. These lesions are not attached to the wall of the ventricles.

Biophysical Profile and Color Doppler Ultrasound in the High Risk Pregnancy Presented by: Dr. Farzad Afzali Kasra Ultrasound Clinic   • BPP is applying to detect prenatal asphyxia • Doppler ultrasound is a modality for detecting fetal hypoxia and acidosis • Doppler can also predict later pre- eclampsia at the 24-26 gestational weeks.   • Hypoxia: Low oxygen tension • Asphyxia: Low oxygen and high CO2 • Ischemia: Drop in blood flow Comment So, Doppler ultrasound can predict fetal distress sooner than BPP   • Prediction of the effect of an asphyxial insult on the fetus requires a measure of:

The foetal blood in the chorionic villi is separated from the maternal blood, in the intervillous spaces, by the Placental Barrier which is composed of :1. Endothelium of the foetal blood vessels, 2. The villous stroma, 3. The cytotrophoblast, and 4. The syncytiotrophoblast.

HELLP Syndrome as a Separate Entity Dr. Mohammed Abdalla EGYPT, Domiat G. HospitalHELLP Syndrome May it be a separate entity? yes   HELLP, a syndrome characterized by hemolysis, elevated liver enzyme levels and a low platelet count, is an obstetric complication that is frequently misdiagnosed at initial presentation. Many investigators consider the syndrome to be a variant of preeclampsia, but it may be a separate entity.

DEFINITIONExcessive blood loss sufficient to affect the general condition of the mother.INCIDENCELow parity 0.3%Para 4 or > 2%Babiszki et al, 1999

Generalized skin thickening of more than 5mm and / or two or more of the following • Pericardial Effusion • Pleural Effusion • Ascites • Placental Enlargement