Haemoperitoneum is a rarely reported but life-threatening complication of a multitude of disease processes that can affect horses. This report describes an unusual case of haemoperitoneum in a pregnant mare attributed to a unilateral ovarian haematoma during early gestation. The mare was treated with supportive care and discharged 8 days after initial presentation. Following discharge, the mare maintained her pregnancy to term and delivered a live colt at 321 days of gestation.
A case of spontaneous calculous perforation of the common hepatic duct is presented. The late result of duct repair, that of stricture formation, is illustrated.
Objective
Maternal diabetes substantially increases the risk of late IUD. A greater understanding of the underlying mechanism might allow identification of pregnancies at increased risk. We have studied post-mortem reports to investigate differences between IUD of fetuses from women with and without diabetes.
Methods
From the Centre for Maternal and Child Enquiries (CMACE), we obtained post mortem reports of cases of perinatal death in women with and without diabetes. Case pairs were matched for gestational age, birth weight, maternal BMI, deprivation index and ethnicity. We excluded cases/controls with multiple birth, lethal congenital abnormality, and neonatal death.
Results
Data are presented on 24 pairs; gestational ages ranged from 173 to 280 days and birth weights from 150 to 4650g. In women with diabetes, the mean placental weight was significantly less than in controls (328g vs 399g; p=0.034; 95% confidence interval -135 to -6g) and the gestational age corrected placental weight was 0.81 (SEM 0.41) standard deviations below population reference values (P=0.05). Brain and spleen weights were significantly lower in the infants of diabetic mothers (brain: mean 235 (SEM 25)g vs 274 (27)g; p=0.032; spleen: 3.5 (0.7)g vs 5.5 (1.1)g; p=0.04). There was a trend for the thymus and liver to be lighter and the heart heavier in the fetuses of diabetic mothers.
Conclusion
In pregnancies in women with diabetes which end in late IUD, the placenta, brain and spleen are lighter than in controls and we postulate placental and organ growth may identify diabetic women at risk of IU.
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