Case report

MOTHER’S SINUS TACHYCARDIA AS A CAUSE OF UNRECOGNIZED FETAL DEATH

Oleg Petrović ; Klinika za ginekologiju i porodništvo, Klinički bolnički centar Rijeka, Cambierieva 17, 51 000 Rijeka, Hrvatska
Nebojša Sindik ; Klinika za ginekologiju i porodništvo, Klinički bolnički centar Rijeka, Cambierieva 17, 51 000 Rijeka, Hrvatska
Tea Štimac ; Klinika za ginekologiju i porodništvo, Klinički bolnički centar Rijeka, Cambierieva 17, 51 000 Rijeka, Hrvatska
Ljiljana Randić ; Klinika za ginekologiju i porodništvo, Klinički bolnički centar Rijeka, Cambierieva 17, 51 000 Rijeka, Hrvatska

Abstract

Late fetal death was and still is a very sad and disappointing outcome of pregnancy. However, today, with all the classic and modern facilities at our disposal, it is really unacceptable that late fetal death remains unrecognized by qualified medical professionals at the beginning of labor. The authors have decided to present such an extremely rare case of unrecognized fetal death at the 39th week of singleton pregnancy in 19 years old primipara with sinus tachycardia which was recorded by external electronic fetal heart monitoring and mistakenly interpreted as normal fetal heart rate. The lack of timely diagnosis of gestational diabetes probably had resulted in undesirable fetal complications such as metabolic disorders, macrosomia and intrauterine fetal death, caused by fetal hypoxia and acidosis. Analysing the whole course of delivery a few fundamental obstetric rules were omitted: taking the patient’s medical history was done quite inadequately (nobody asked her about previous attack of tachycardia and fetal movements), and the simple auscultation of the fetal heartbeat with simultaneous checking of the maternal radial pulse rate was ignored, leading to an unacceptable situation, where intrauterine fetal death was unrecognized through the first 3 hours of labor. The authors offer a clinical opinion that the obstetricians, as well as midwifes have to use modern medical technology and diagnostic tests wisely and critically, but can never allow themselves to skip the simple propaedeutic rules of obstetric care. Only with the better collaboration of the patient and with a watchful and critical analysis of the complete medical documentation and diagnostic tests, it could be possible to correct possible own or somebody else’s professional errors.

Keywords

gestational diabetes; cardiotocography; late fetal death; sinus tachycardia

Hrčak ID:

68434

URI

https://hrcak.srce.hr/68434

Publication date:

1.6.2010.

Article data in other languages: croatian

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