Muerte súbita en embarazada por embolia trofoblástica vs. tiroiditis vs. canalopatía
- María Paz Suárez-Mier
- Juan Pedro Hernández-del Rincón
- Carmen Torres-Sánchez
- María Sabater-Molina
- Juan Ramón Gimeno-Blanes
ISSN: 0377-4732
Año de publicación: 2020
Volumen: 46
Número: 2
Páginas: 81-84
Tipo: Artículo
Otras publicaciones en: Revista española de medicina legal: órgano de la Asociación Nacional de Médicos Forenses
Objetivos de desarrollo sostenible
Resumen
A 43-year-old, 37-week-pregnant woman with normal periodic controls dies suddenly after nausea and vomiting. A complete forensic autopsy is performed with histopathological study of all organs (maternal and foetal), and toxicological and genetic analysis. The main findings were: multiple trophoblastic embolism in the lung; extensive chronic lymphocytic thyroiditis; and focal hypophysitis. Genetic analysis demonstrated a polymorphism in the SCN5A gene of the sodium channel. There are three possible causes of death: 1) trophoblastic embolism; 2) arrhythmia due to electrolyte disturbance associated with hypothyroidism and enhanced by nausea and vomiting; 3) long QT syndrome due to hyperthyroidism and polymorphism in the SCN5A gene. This case illustrates that determination of cause of death during pregnancy or puerperium can be very complex, so the autopsy must be exhaustive including histopathological study of the endocrine organs, and genetic and biochemical analysis