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Arteriovenous malformation of vein of Galen as a rare non‐hypoxic cause of changes in fetal heart rate pattern during labor
Author(s) -
Biringer Kamil,
Zubor Pavol,
Kudela Erik,
Kolarovszki Branislav,
Zibolen Mirko,
Danko Jan
Publication year - 2016
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12909
Subject(s) - medicine , cardiotocography , fetus , hypoxia (environmental) , arteriovenous malformation , decompensation , umbilical cord , pregnancy , gestational age , obstetrics , cardiology , surgery , chemistry , genetics , organic chemistry , anatomy , oxygen , biology
The aim of this case report is to describe a rare non‐hypoxic cause of pathological changes in fetal heart rate pattern during labor, and to determine management, including a description of important prenatal aspects when pathologic cardiotocographic recording is performed during labor. A fetus with rare arteriovenous malformation of the vein of Galen, which represents less than 1% of all intracranial arteriovenous malformations, was monitored by intrapartum external cardiotocography in the 37 + 5 gestational week. The baby was born by cesarean section because of signs of imminent intrauterine hypoxia on cardiotocography. However, metabolic acidosis was not confirmed in umbilical cord blood sampling. Despite intensive neonatal care management, the newborn died 31 h after delivery because of progressive cardiac decompensation, hypotension and multi‐organ failure. Precise diagnosis of the abovementioned pathology, a pre‐labor plan for delivery and postnatal prognosis assessment can significantly contribute to the avoidance of a misdiagnosis of fetal hypoxia and unnecessary operative delivery with marked medico‐legal consequences.