We report two cases of generalized nonviolent hepatogenic fat embolism. A 63-year-old woman was sent to the hospital with suspected mushroom poisoning. Shock symptoms occurred quickly and could not be treated effectively; the patient died 24 h after admission. Postmortem examination showed acute yellow dystrophy of the liver with a severe preexisting fatty liver. Any intoxication including Amanita phalloides could be excluded. In all probability, a fulminant viral hepatitis caused liver dystrophy, and the decay of the fatty liver cells led to generalized fat embolism as the cause of death. The second patient, a 46-year-old man, was reported to have suffered from an acute illness while in prison and died after having been transferred to the local hospital. Histological examinations showed an acute liver dystrophy probably caused by fulminant viral hepatitis with fatty degeneration. In this case, the cause of death was also found to be generalized fat embolism.
Objective: Congenital heart defects (CHDs) are the most common cause of infant death in the United States. Severe, complex cardiac anomalies make up approximately half of the cases and carry significant morbidity and mortality. The purpose of this literature review was to define a CHD screening protocol to be used in the first trimester. Methods: Literature was pulled that discussed the impact of color Doppler and spatiotemportal image correlation on image quality, explored the benefits and limitations of early screening, and analyzed the risk of bioeffects to the developing fetus. Results: A simplified cardiac screening protocol has been shown to be a feasible addition to the first trimester nuchal translucency scan. Conclusion: Color Doppler and three-dimensional sonography can be utilized during the first trimester to evaluate the fetal heart for major anomalies between 11 weeks and 13 weeks 6 days. Recommendations for future research and guidance from accrediting bodies are provided.
Hypoplastic left heart syndrome (HLHS) comprises a spectrum of left-sided heart anomalies resulting from left outflow or inflow obstruction. Obstruction most often occurs at the levels of the aortic valve and/or mitral valve due to stenosis or atresia. HLHS is a lethal cardiac anomaly if not treated within the first week of life. Knowledge of sonographic features could aid in early detection, which results in better planning and management of pregnancy. This report presents a case in which HLHS was discovered during a routine dating and viability sonogram, performed at 12 weeks’ gestation.
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