Unexpected sudden death in pregnancy – arrhythmogenic right ventricular cardiomyopathy/dysplasia: a case report

Vadysinghe, Amal Nishantha; Jayasooriya, R. P.; Gunatilake, G. Keerthi Kumara; Sivasubramanium, Murugupillai

doi:10.1080/20961790.2017.1325548

Cited by 4 publications

(3 citation statements)

References 23 publications

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“…Majority of sudden deaths during the puerperium results from cardiovascular and gynecological conditions and holds medicolegal significance particularly if associated with criminal abortion or medical negligence (Vadysinghe A. et al 2017). However, it should not be forgotten that physiological changes in pregnancy itself can predispose an individual to be ended up in a sudden death.…”

Section: Discussionmentioning

confidence: 99%

Choking together with aspiration of gastric contents: rare form of maternal death

Vadysinghe

Nayakarathne

Banda³

et al. 2022

Egypt J Forensic Sci

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Background The common causes of early postpartum maternal deaths are cardiomyopathies, obstetric hemorrhage, hypertensive disorders, and sepsis. However, a maternal death from choking together with aspiration of gastric contents is a rare occurrence to be diagnosed at the autopsy examination. Case presentation A 27-year-old previously healthy lady developed breathlessness 48 h after delivery, while on supine position, 1 h after meals, and pronounced death on admission. Autopsy was insignificant except for large amount of gastric contents in the air ways. Microscopic examination revealed bronchioles filled with eosinophilic materials and a significant number of neutrophil infiltrations at the margin. Alveoli were free from edema fluid and inflammatory cells. Some alveoli were expanded with broken septae. Cause of death was airway obstruction due to choking together with aspiration of gastric contents. Conclusions Aspiration of gastric contents can cause sudden unexpected death at postpartum, and it is recommended to educate immediate and early postpartum mothers regarding the risk of aspiration.

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Section: Discussionmentioning

confidence: 99%

Choking together with aspiration of gastric contents: rare form of maternal death

Vadysinghe

Nayakarathne

Banda³

et al. 2022

Egypt J Forensic Sci

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“…Only case reports [ 1 , 3 , 15 , 22 , 23 , 30 , 33 , 34 , 54 , 61 ] and small series [ 5 , 7 , 9 , 36 ] with a total of 30 pregnancies in 30 women with AC had been reported prior to the first larger case studies and registry reports on pregnancy in AC that were recently published ([ 13 , 27 , 31 , 48 , 69 ]; Tables 1 and 2 ). All reported pregnancies in AC were singleton.…”

Section: Outcomes Of Pregnancy In Women With Acmentioning

confidence: 99%

Pregnancy in arrhythmogenic cardiomyopathy

Wichter

Milberg²,

Wichter³

et al. 2021

Herzschr Elektrophys

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Arrhythmogenic cardiomyopathy (AC) is a rare heart muscle disease with a genetic background and autosomal dominant mode of transmission. The clinical manifestation is characterized by ventricular arrhythmias (VA), heart failure (HF) and the risk of sudden cardiac death (SCD). Pregnancy in young female patients with AC represents a challenging condition for the life and family planning of young affected women. In addition to genetic mechanisms that influence the complex pathophysiology of AC, experimental and clinical data have confirmed the pathogenetic role of strenuous exercise and competitive sports in the early onset and rapid progression of AC symptoms and complications. Pregnancy and exercise share a number of physiological aspects of adaptation. In AC, both result in ventricular volume overload and myocardial stretch. Therefore, pregnancy has been postulated as a potential risk factor for HF, VA, SCD, and pregnancy-related obstetric complications in patients with AC. However, the available evidence on pregnancy in AC does not confirm this hypothesis. In most women with AC, pregnancies are well tolerated, uneventful, and follow a benign course. Pregnancy-related symptoms (VA, syncope, HF) and mortality, as well as obstetric complications, are uncommon in AC patients and range in the order of background populations and cohorts with AC and no pregnancy. The number of completed pregnancies is not associated with an acceleration of AC pathology or an increased risk of VA or HF during pregnancy and follow-up. Accordingly, there is no medical indication to advise against pregnancy in patients with AC. Preconditions include stability of rhythm and hemodynamics at baseline, as well as clinical follow-ups and the availability of multidisciplinary expert consultation during pregnancy and postpartum. Genetic counseling is recommended prior to pregnancy for all couples and their families affected by AC.

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“…Indirect causes are leading maternal deaths, with heart disease being the most common. 1,2,3 Sri Lanka has a maternal mortality ratio of 33.7 per 100,000 live births, which is the lowest rate in South Asia. 4 Even though among the causes of death in pregnancy, incidents of infective endocarditis are rare as 0.006%, 5,6,7 maternal mortality rate as well as fetal mortality rate is significantly high as 22.1% and 14.7% respectively.…”

Section: Introductionmentioning

confidence: 99%

Maternal death due to health care associated native valve

Perera

Gangahawatte

2019

Sri Lanka J Forensic Med, Sci & Law

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Infective endocarditis in pregnancy is a rare disease accounting for 0.006% of incidents. Among the associated factors health care associated fatal infections are rarer. In this case a pregnant mother with 13 weeks of gestation was subjected to the autopsy with the history of fever following inward treatment for hyperemesis, which was the result of septic thrombophlebitis at cannula site. Suggested clinical diagnosis of bacterial endocarditis was confirmed macroscopically and microscopically during autopsy. Damage to the mitral valve, micro abscess formation, multiple thrombi formation and infractions in the organs, together with features of heart failure was evident as complications of bacterial endocarditis. This rare case highlights that the need of early diagnosis of bacterial endocarditis when a pregnant mother presents with fever and necessity of adherence to the infection control standard in clinical setting to prevent mortality and morbidity.

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Unexpected sudden death in pregnancy – arrhythmogenic right ventricular cardiomyopathy/dysplasia: a case report

Cited by 4 publications

References 23 publications

Choking together with aspiration of gastric contents: rare form of maternal death

Choking together with aspiration of gastric contents: rare form of maternal death

Pregnancy in arrhythmogenic cardiomyopathy

Maternal death due to health care associated native valve

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