{"id":2133,"date":"2024-11-12T10:07:26","date_gmt":"2024-11-12T10:07:26","guid":{"rendered":"https:\/\/live-champs-new.pantheonsite.io\/?post_type=resource&#038;p=2133"},"modified":"2024-11-17T18:44:52","modified_gmt":"2024-11-17T18:44:52","slug":"a-stillbirth-caused-by-lack-of-oxygen-as-a-result-of-prolonged-obstructed-labor-due-to-congenital-malformation","status":"publish","type":"resource","link":"https:\/\/champshealth.org\/resource\/a-stillbirth-caused-by-lack-of-oxygen-as-a-result-of-prolonged-obstructed-labor-due-to-congenital-malformation\/","title":{"rendered":"A stillbirth caused by lack of oxygen as a result of prolonged obstructed labor due to congenital malformation"},"content":{"rendered":"\n<div class=\"wp-block-cover alignfull page-header-standard\"><span aria-hidden=\"true\" class=\"wp-block-cover__background has-background-dim-70 has-background-dim\" style=\"background-color:#a45d9d\"><\/span><img loading=\"lazy\" decoding=\"async\" width=\"1476\" height=\"912\" class=\"wp-block-cover__image-background wp-image-2134\" alt=\"\" src=\"https:\/\/live-champs-new.pantheonsite.io\/wp-content\/uploads\/2024\/11\/2019-0671-SLAA00546-A-Liver-Pauvity-of-bile-duct.jpg\" data-object-fit=\"cover\" srcset=\"https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2019-0671-SLAA00546-A-Liver-Pauvity-of-bile-duct.jpg 1476w, https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2019-0671-SLAA00546-A-Liver-Pauvity-of-bile-duct-300x185.jpg 300w, https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2019-0671-SLAA00546-A-Liver-Pauvity-of-bile-duct-1024x633.jpg 1024w, https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2019-0671-SLAA00546-A-Liver-Pauvity-of-bile-duct-768x475.jpg 768w\" sizes=\"auto, (max-width: 1476px) 100vw, 1476px\" \/><div class=\"wp-block-cover__inner-container is-layout-flow wp-block-cover-is-layout-flow\">\n<p class=\"has-text-align-center\">CHAMPS RESOURCES<\/p>\n\n\n\n<h2 class=\"wp-block-heading text-center\">CHAMPS Resources<\/h2>\n<\/div><\/div>\n\n\n<div class=\"publication-meta\"> \n\n<p class=\"publication-date\"> April 25, 2022 <\/p>\n\n<div class=\"publication-share\">\n\n<span class=\"share\">Share: <\/span> <ul> \n\n<li class=\"publication-share-facebook\"> <a href=\"\"> <i class=\"fa fa-facebook\"> <\/i> <\/a><\/li>\n<li class=\"publication-share-facebook\"> <a href=\"\"> <i class=\"fa-brands fa-x-twitter\"><\/i> <\/a><\/li>\n<li class=\"publication-share-instagran\"> <a href=\"\"> <i class=\"fa-brands fa-instagram\"><\/i> <\/a><\/li>\n\n<\/ul>\n <\/div>\n <\/div>\n\n <p class=\"publication-title\">A stillbirth caused by lack of oxygen as a result of prolonged obstructed labor due to congenital malformation <\/p>\n\n\n<div class=\"wp-block-group content-white\"><div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n<p class=\"has-text-align-left w-65 margin-auto\">A seemingly uncomplicated delivery resulted in the death of mother and baby when a previously undiagnosed congenital malformation caused obstructed labor.&nbsp;The mother went into labor&nbsp;at&nbsp;36 weeks in her&nbsp;home&nbsp;at 18:00 in the evening. In the morning, the family proceeded to the hospital,&nbsp;and by early afternoon&nbsp;the&nbsp;delivery seemed to be progressing normally. The baby presented as&nbsp;breech, and its body&nbsp;was delivered without difficulty; however, the head&nbsp;and shoulders&nbsp;became&nbsp;stuck,&nbsp;and no maneuvering could&nbsp;complete the delivery.&nbsp;The&nbsp;mother was moved to&nbsp;an operating room, but both the doctor and surgical attendant were unavailable.&nbsp;This delay in delivery resulted in prolonged absence of oxygen to the&nbsp;baby and subsequent&nbsp;intrapartum demise.&nbsp;After&nbsp;several&nbsp;hours, vaginal&nbsp;delivery was completed&nbsp;when the surgical attendant&nbsp;arrived.&nbsp;Unfortunately, the mother experienced a massive&nbsp;postpartum hemorrhage. An immediate blood transfusion was&nbsp;initiated, but the mother died during resuscitation.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Uncovering the Cause<\/h2>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p>Examination of the baby by the CHAMPS team revealed a congenital malformation of the baby\u2019s head known as hydrocephalus, meaning the baby\u2019s head was enlarged due to a buildup of cerebrospinal fluid. The skull had been fractured during labor manipulations.&nbsp;&nbsp;&nbsp;<\/p>\n\n\n\n<p>Pathology findings in the liver showed a paucity working bile ducts. A marked decrease in the amount of bile ducts, combined with hydrocephalus may be indicative of a genetic disorder.&nbsp;&nbsp;<\/p>\n\n\n\n<p class=\"has-text-align-left w-65 margin-auto\"><strong>Pathology images<\/strong>:<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"633\" src=\"https:\/\/live-champs-new.pantheonsite.io\/wp-content\/uploads\/2024\/11\/2019-0671-SLAA00546-A-Liver-Pauvity-of-bile-duct-lower-magniification-EMH-1024x633.jpg\" alt=\"\" class=\"wp-image-2135\" srcset=\"https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2019-0671-SLAA00546-A-Liver-Pauvity-of-bile-duct-lower-magniification-EMH-1024x633.jpg 1024w, https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2019-0671-SLAA00546-A-Liver-Pauvity-of-bile-duct-lower-magniification-EMH-300x185.jpg 300w, https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2019-0671-SLAA00546-A-Liver-Pauvity-of-bile-duct-lower-magniification-EMH-768x475.jpg 768w, https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2019-0671-SLAA00546-A-Liver-Pauvity-of-bile-duct-lower-magniification-EMH.jpg 1476w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><figcaption class=\"wp-element-caption\"><strong>Lower magnification of liver showing\u00a0extracellularly hematopoiesis\u00a0<\/strong><\/figcaption><\/figure><\/div>\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"633\" src=\"https:\/\/live-champs-new.pantheonsite.io\/wp-content\/uploads\/2024\/11\/2019-0671-SLAA00546-A-Liver-Pauvity-of-bile-duct-1024x633.jpg\" alt=\"\" class=\"wp-image-2134\" srcset=\"https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2019-0671-SLAA00546-A-Liver-Pauvity-of-bile-duct-1024x633.jpg 1024w, https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2019-0671-SLAA00546-A-Liver-Pauvity-of-bile-duct-300x185.jpg 300w, https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2019-0671-SLAA00546-A-Liver-Pauvity-of-bile-duct-768x475.jpg 768w, https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2019-0671-SLAA00546-A-Liver-Pauvity-of-bile-duct.jpg 1476w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><figcaption class=\"wp-element-caption\"><strong>Portal tract\u00a0shows artery and vein but not bile\u00a0duct.<\/strong><\/figcaption><\/figure><\/div>\n\n\n<h2 class=\"wp-block-heading\">Family Follow-up<\/h2>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p>The father was interested in learning about the baby\u2019s cause of death and was receptive to the cause of death results presented at the family follow-up session. Prior to receiving the information, he had not understood why the delivery had been so difficult. CHAMPS\u2019 protocol allowed the team to explain what had caused the death of his wife and baby and provided information around early detection of birth defects.&nbsp;<\/p>\n\n\n\n<p>It is crucial to note that, while genetic testing could be an important preventative tool here, it is not widely available in the places where CHAMPS works. Improving access and standards for prenatal care may have prevented the obstructed labor, but it is not possible to tell whether the birth would have been viable, even if the baby was delivered by C-section.&nbsp;&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Public Health Implications<\/h2>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p>This CHAMPS case emphasizes the need for protocols for prenatal care with proper documentation as well as supportive supervision of healthcare workers.&nbsp;This mother attended prenatal visits where there were opportunities to capture both the breech presentation and hydrocephalus; however, she only sought prenatal care twice during pregnancy, and her clinical record indicated gaps in assessments. There was no indication of nutritional counseling during her visits, despite poor weight gain, no discussion of completing an ultrasound, and no detailed documentation that the baby was positioned breech. When the mother presented in labor there was no documentation of fetal positional or heart rate and no partograph record.&nbsp;&nbsp;<\/p>\n\n\n\n<p>There is an opportunity to provide feedback to midwife training schools and Maternal &amp; Child Aide training courses regarding the need for proper screenings that could make a critical difference.&nbsp;An increased need to support healthcare professionals to encourage and facilitate prompt responses in situations like this case. A prompt response from the doctor on call may have made a significant difference in this case.&nbsp;&nbsp;<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p class=\"has-text-align-center\"><strong>Interested in more CHAMPS updates?<\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center\"><a href=\"https:\/\/ianphi.us1.list-manage.com\/subscribe?u=11ad46d81331e83cdf62a0d0a&amp;id=7fc15b483f\" target=\"_blank\" rel=\"noreferrer noopener\">Sign up for our mailing list!<\/a><\/p>\n\n\n\n<p class=\"has-text-align-center\">Email&nbsp;<a href=\"mailto:data@champshealth.org\">data@champshealth.org<\/a>&nbsp;for information about CHAMPS pathology slide images.<\/p>\n<\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>A seemingly uncomplicated delivery resulted in the death of mother and baby when a previously undiagnosed congenital malformation caused obstructed labor.&nbsp;The mother went into labor&nbsp;at&nbsp;36 weeks in her&nbsp;home&nbsp;at 18:00 in the evening. In the morning, the family proceeded to the hospital,&nbsp;and by early afternoon&nbsp;the&nbsp;delivery seemed to be progressing normally. The baby presented as&nbsp;breech, and its [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/champshealth.org\/resource\/a-stillbirth-caused-by-lack-of-oxygen-as-a-result-of-prolonged-obstructed-labor-due-to-congenital-malformation\/\">Read More&#8230;<span class=\"screen-reader-text\"> from A stillbirth caused by lack of oxygen as a result of prolonged obstructed labor due to congenital malformation<\/span><\/a><\/p>\n","protected":false},"author":3,"featured_media":2134,"parent":0,"template":"","meta":{"_acf_changed":false,"footnotes":""},"tags":[],"resource_category":[9],"class_list":["post-2133","resource","type-resource","status-publish","has-post-thumbnail","hentry","resource_category-case-example"],"acf":[],"_links":{"self":[{"href":"https:\/\/champshealth.org\/wp-json\/wp\/v2\/resource\/2133","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/champshealth.org\/wp-json\/wp\/v2\/resource"}],"about":[{"href":"https:\/\/champshealth.org\/wp-json\/wp\/v2\/types\/resource"}],"author":[{"embeddable":true,"href":"https:\/\/champshealth.org\/wp-json\/wp\/v2\/users\/3"}],"version-history":[{"count":2,"href":"https:\/\/champshealth.org\/wp-json\/wp\/v2\/resource\/2133\/revisions"}],"predecessor-version":[{"id":2245,"href":"https:\/\/champshealth.org\/wp-json\/wp\/v2\/resource\/2133\/revisions\/2245"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/champshealth.org\/wp-json\/wp\/v2\/media\/2134"}],"wp:attachment":[{"href":"https:\/\/champshealth.org\/wp-json\/wp\/v2\/media?parent=2133"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/champshealth.org\/wp-json\/wp\/v2\/tags?post=2133"},{"taxonomy":"resource_category","embeddable":true,"href":"https:\/\/champshealth.org\/wp-json\/wp\/v2\/resource_category?post=2133"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}