[Selective reduction of fetuses in the bitch using induction of fetal death by ultrasound guidance]

Unwanted pregnancy termination is a big issue for dog owners. In this study we attempted to reduce the number of fetuses in pregnant bitches through ultrasound-guided induced fetal death. The study was performed on 6 privately owned crossbred pregnant bitches, in the second and third trimester of pregnancy, with variable number of fetuses [n=2 to 8]. Fetal death was induced by transabdominal injection of potassium chloride [KCl] into the fetal cardiac chamber under ultrasonographic guidance. While selective fetal reduction was successfully achieved in 4 bitches [66.6%] 2 bitches showed complete pregnancy termination. Data presented in this research provide evidence for possible use of this technique in order to selectively reduce the number of fetuses without whole pregnancy termination in the bitch. Ultrasound-guided induced fetal death seems to be a safe procedure and a viable method for reducing the number of fetuses with no side effect in the bitch

Acute fatty liver of pregnancy complicated with ascites and bilateral pleural effusion

Acute liver failure may be caused by fulminant viral hepatitis, drug-induced hepatic toxicity, or acute fatty liver of pregnancy. Acute fatty liver of pregnancy is a rare condition that is estimated to affect 1 in 7000 to 16000 pregnancies in the third trimester of pregnancy. The maternal mortality rate has been estimated to be 18%, and neonatal mortality rates have ranged from 7% to 58%. Early diagnosis and treatment, will improve the consequences of the disease in fetuses and mother. A 24-year old woman, gravid 1, was admitted in our hospital with term pregnancy because of labour pain, nausea, vomiting and jaundice. Diagnosis of acute fatty liver of pregnancy was made in this case on the basis of the clinical and para clinical findings. After correction of the coagulation defect with 3 units of FFP, caesarean section was performed because of lack of progression of labour and presence of meconium stain in amniotic fluid. 3 days after the operation, the patient developed ascites and bilateral pleural effusion. Intensive care and supportive measures after caesarean section led to improved hepatic function. We recommend evaluation of liver and kidney function tests and a complete blood count in all patients with nausea, persistent vomiting, or epigastric pain in the third trimester of pregnancy to rule out the diagnosis of acute fatty liver of pregnancy