Mrs. Rabeya 25 years old, muslim housewife, hailing from Taraganj , Rangpur, got admitted to RpMCH with the complaints of –
- Pregnancy for 23 weeks 5 days
- Less fetal movement for 2 days
- No fetal movement for 6 hours
- H/O high grade fever 5 days back
According to statement of the patient she was amenorrheic from 22 weeks. Her LMP was 0n 06/08/2022 & accordingly EDD would be on 13/07/2023 (04/08/2022, according to USG) Her pregnancy was confirmed by urine for pregnancy test. It was her planned pregnancy. She was on regular antenatal checkup and had normal BP in her early antenatal visits. Her pregnancy was uneventful upto 21 weeks .
Then, She has developed high grade fever 5 days back that was treated by local doctor and she couldn’t mention the name of drugs,Then she noticed less fetal movement for 2 days, and no fetal movement for 6 hours. Then she consulted with an obstetrician and USG was done.After that she was diagnosed as a case of IUD and was advised to admit in Rangpur Medical College Hospital.
She was normotensive, non diabetic, had no history of chronic medical or any surgical illness. She had taken calcium, folic acid & iron tablets regularly & had got TT vaccine as per schedule.
She was non-smoker, non alcoholic & belongs to middle class family, none of her family members suffered from such kind of illness.
General physical examination: After counselling , taking consent & maintained proper privacy with presence of a female attendant she was examined and found anxious but co-operative, body built & nutritional status average, mildly anemic , non icteric, not edematous. Pulse-80 b/m, BP- 120/80 mmhg, Respiratory rate- 16 b/m. Temperature- 99℉. Thyroid gland -not enlarged.
Per Abdominal Examination
SFH-18 weeks There was a single fetus with longitudinal lie & cephalic presentation. Linea nigra and Striae gravidarum were present.
Per vaginal examination
So from history, my Clinical diagnosis is-
“Primi gravida 20 weeks pregnancy with Intrauterine Fetal Death’’