Severe maternal hypoxemia during a twin pregnancy.
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The author describes a case of vaginal delivery in which the mother dies. Because of a retained placenta parts in cavum uteri, the physician peroformed revisio cavi uteri instrumentalis, in which wall of the uterus is perforated, about 3 cm in length. A justice commission of seven persons associate the bleeding out of the uterus and the death of the mother with the perforation of the uterus. We consider that the death of the mother is due to amniotic embolism and not due to the perforation of the uterus. We cite contemporary scientific data.
OBJECTIVE: To determine the maternal mortality ratio (MMR) in Department of Defense medical facilities from 1993 to 1998. STUDY DESIGN: We conducted a retrospective review of birth data from military medical facilities using the Standard Inpatient Data Records from 1993 through 1998. The total number of live births and dispositions due to maternal death were obtained. RESULTS: Twenty-two maternal deaths occurred in the study time out of 398,107 live births, for an MMR of 5.5 per 100,000 live births. The ratiosfor the service branches were: Army 7.0, Navy 5.3 and Air Force 3.6. The leading cause of death was embolic disease. CONCLUSION: The military MMR is closer to the Healthy People 2010 goal of 3.3 than is the national ratio, 13.2. Improved reporting of cases, patient education and treating high-risk conditions may help further decrease pregnancy-related mortality.
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A case of the shock lung with numerous hyalin membranes is described in a 19-year-old woman after the delivery with a consequent acute respiratory failure. Bacterial shock, acute respiratory disease, possible embolism with amniotic fluid in combination with hypercoagulation typical for pregnancy are named among the causes of the shock lung development. A partial resolution and marked organization of the hyalin membranes are observed.