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2012-06-13-16 Incomplete rupture of amniotic membrane ©Othman Al-Asali

Incomplete rupture of amniotic membrane

Othman Al-Asali

Maternity Department, Al-Hammadi Hospital, Riyadh, Saudi Arabia

Case report:

A 25-year-old patient,G2P1, non-consanguineous marriage had first normal pregnancy. In this pregnancy, she had normal antenatal care with negative TORCH group at 18 weeks, ultrasound showed a viable fetus of 19 weeks 3 days. Placenta was posterior upper segment. Amniotic fluid was adequate. The membranes floated in the amniotic cavity.

Two weeks later, she was admitted for lower abdominal pain and leaking amniotic fluid. Ultrasound scanning revealed severe oligohydramnios.
There were multiple amniotic membranes denoting rupture of amnion, there was a history of serosangunious fluid loss.
Estimate fetal body weight was 323 grams.
The patient stayed in hospital for 5 days, the baby died in utero. The stillbirth was born by Cytotec-induced delivery and weighed 470gr with no apparent congenital appearence outside. 

The placenta remained inside the uterus was removed manually, unfortunately, it was adherent to the uterus and removed in pieces.

Image 1, 2, 3: At 18 weeks, sufficient amniotic fluid with the amniotic membrane floating in the amniotic cavity

Image 4, 5: 
Normal heart rate and cervical view at 18 weeks

Image 6, 7: Severe oligohydramnios and the cervical view at 20 weeks

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