Cardiovascular causes of maternal sudden death. Sudden Arrhythmic Death Syndrome is leading cause in UK

Sudden death of a pregnant woman because of massive aspiration-case report and review of literature

INTRODUCTION

Massive aspiration of gastric contents as a cause of death in pregnancy without anesthesia is possible, but is not documented in the available literature as a separate case report.

AIM

To describe sudden death of a pregnant woman because of massive aspiration of gastric contents.

CASE REPORT

The presence of a valvular anomaly in a 26-year-old woman had been known since childhood: the prolapse of both mitral cusps. In the 34th week of her second pregnancy, after dinner, she went to take a shower when she collapsed with abundant vomiting of stomach contents. The ambulance came in 20 min and started a resuscitation procedure which was unsuccessful, and the death of the pregnant woman was established in the 34th week of pregnancy. Autopsy revealed massive aspiration of gastric contents into the trachea and bronchi, pulmonary edema, and generalized cyanosis. Left ventricular dilatation was found in the heart, with prolapse of both mitral valve cusps.

CONCLUSION

Sudden deaths in pregnancy are rare and dramatic conditions in emergency medicine. Cardiac checkups are very important for pregnant women with heart failures or heart anomalies, and must be recommended by gynecologists.

Sudden Death in Congenital Heart Disease: The Role of the Autopsy in Determining the Actual Cause

Congenital heart defects (CHDs) have undergone a large change in epidemiology due to prenatal screening and improved outcomes with surgery and percutaneous procedures. In patients with complex CHD there is an increased risk of sudden cardiac death (SCD) and up to 11% of all SCDs in the young occur in people with CHD. It is essential for clinicians to be aware of the risk factors, and for all patients to be followed up in specialised centres. When an SCD occurs, it is important that an autopsy is done and for the pathologist to have an in-depth knowledge of the particular defect and the corrective surgical techniques employed, as well as any complications due to these procedures. Both pathologist and cardiologist should work closely together to explain the cause of death to the family. A terminal cardiac arrhythmia explains many of the SCD cases, often with underlying cardiac fibrosis due to previous procedures. SCD may also be the first presentation of CHD, so great care is required when examining such cases and referral for a detailed expert opinion is recommended in all CHD-SCD cases.