The fetal death rate associated with cardiac operations using cardiopulmonary bypass in pregnant women is as high as 9.5% to 29%. We present a case in which fetal heart rate and umbilical artery flow velocity waveforms were continuously monitored by transvaginal ultrasonography and analyzed in relation to events of the cardiopulmonary bypass. Our findings suggest that hypothermia during cardiopulmonary bypass has potentially deleterious effects on the fetus and should be avoided if possible.

Intrauterine fetal brain death is a rare cause of a fixed fetal heart rate pattern. Seven cases have been previously reported in the literature, but only two of them were diagnosed prenatally and all the newborns died soon after delivery. Two additional cases of antepartum diagnosis of intrauterine fetal brain death, managed expectantly, are reported. We had the unique opportunity to document progressive sonographic cerebral changes during the follow-up period, following the neurological event, while the fetus continued life and growth in utero. The cardiographic and sonographic findings suggesting intrauterine fetal brain death were a prolonged fixed fetal heart rate, even following a vibroacoustic and contraction stress test; an atonic fetus without breathing and body movement; and the appearance of hydramnios and the development of ventriculomegaly.

(1988). Spontaneous haemothorax in pregnancy. Journal of Obstetrics and Gynaecology: Vol. 8, No. 4, pp. 329-329.