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Background: Intrauterine fetal death is a potential risk in each stage of pregnancy, regardless of the mother’s age. In Poland in 2015, new standards of care were introduced for women with obstetric failure. Aim of the study: This study aimed to analyze intrauterine fetal demise in the context of late motherhood. Material and methods: Medical documentation and a semi-structured interview were used. Case report: A 41-year old primipara in 37 weeks of pregnancy, who had not felt fetal movements for 2 days, was diagnosed with intrauterine fetal demise. The pregnancy was uneventful before, but the patient suffered from hypertension and severe obesity. As a result of induced labor, a male neonate weighing 2260 g, 49 cm long, with no signs of vital functions, was born. After the birth, it was established that the child died due to an umbilical cord accident. The mother was given the appropriate time to see the child for the last time. During delivery and hospitalization, the patient’s privacy was ensured, she was isolated from other women in labor and new mothers and was assisted by her family. During the hospital stay, the patient was under the care of the obstetrician, midwife and clinical psychologist. She was discharged from the hospital after 6 days. Conclusions: The loss of a child is one of the most traumatic experiences for a mother, particularly in the case of older mothers. A woman’s fertility declines with age, so getting pregnant again might prove extremely difficult for older women.
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2006
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tom 53
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nr 1
EN
Linear models based on proportionality between variables have been commonly applied in biology and medicine but in many cases they do not describe correctly the complex relationships of living organisms and now are being replaced by nonlinear theories of deterministic chaos. Recent advances in molecular biology and genome sequencing may lead to a simplistic view that all life processes in a cell, or in the whole organism, are strictly and in a linear fashion controlled by genes. In reality, the existing phenotype arises from a complex interaction of the genome and various environmental factors. Regulation of gene expression in the animal organism occurs at the level of epigenetic DNA modification, RNA transcription, mRNA translation, and many additional alterations of nascent proteins. The process of transcription is highly complicated and includes hundreds of transcription factors, enhancers and silencers, as well as various species of low molecular mass RNAs. In addition, alternative splicing or mRNA editing can generate a family of polypeptides from a single gene. Rearrangement of coding DNA sequences during somatic recombination is the source of great variability in the structure of immunoglobulins and some other proteins. The process of rearrangement of immunoglobulin genes, or such phenomena as parental imprinting of some genes, appear to occur in a random fashion. Therefore, it seems that the mechanism of genetic information flow from DNA to mature proteins does not fit the category of linear relationship based on simple reductionism or hard determinism but would be probably better described by nonlinear models, such as deterministic chaos.
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