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Gynaecology & Obstetrics Miscellaneous (Gynae) c5b75156

X-ray abdomen of a 30-year-old SLE patient who cannot feel her baby moving for past 7 days. All can be seen except:

A
Hyper-flexion of spine
B
Single fetus
C
Anti-Beta 2 glycoprotein antibody
D
Elevated fibrinogen
High-Yield Explanation
Ans. (d) Elevated fibrinogen.* When a dead fetus has been in utero for 3-4 weeks, fibrinogen levels may drop, leading to a coagulopathy. This is rarely a problem because of earlier recognition and induction. In some cases of twin pregnancies, induction after the death of a twin may be delayed to allow the viable twin to mature.* Anti-phospholipid antibody syndrome explains the I.U.D* The irregular overlapping of the cranial bones on one another is due to liquefaction of the brain matter and softening of the ligamentous structures supporting the vault. It usually appears 7 days after death. Similar features may be found in extra-uterine pregnancy with the foetus alive.

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