If the GvHD is severe and requires intense immunosuppression involving steroids and additional agents to get under control, the patient may develop severe infections as a result of the immunosuppression and may die of infection. However, a 2016 study found that the prognosis for patients with grade IV GvHD has improved in recent years. Chronic
The chronic form of graft-versus-host disease (cGvHD) normally begins 90 to 600 days post-transplant. The appearance of moderate to severe cases of cGVHD adversely influences long-term survival.The first symptom of cGvHD is commonly a rash on the palms of the hands or the soles of the feet, and the rash can spread and is usually itchy and dry. In severe cases, the skin may blister and peel, like a bad sunburn. A fever may also develop. Other symptoms of chronic GVHD can include:
Decreased appetite
Diarrhea
Abdominal (belly) cramps
Weight loss
Yellowing of the skin and eyes (jaundice)
Enlarged liver
Bloated abdomen (belly)
Pain in the upper right part of the abdomen (belly)
Increased levels of liver enzymes in the blood (seen on blood tests)
Skin that feels tight
Dry, burning eyes
Dryness or painful sores in the mouth
Burning sensations when eating acidic foods
Bacterial infections
Blockages in the smaller airways of the lungsIn the oral cavity, chronic graft-versus-host disease manifests as lichen planus with a higher risk of malignant transformation to oral squamous cell carcinoma in comparison to the classical oral lichen planus. Oral cancer associated with graft-versus-host disease may have more aggressive behavior with poorer prognosis, when compared to oral cancer in non-hematopoietic stem cell transplantation patients.
Then, the shoulders follow the same path as the hips did. At this time the baby usually turns to face the mothers back. Next occurs external rotation, which is when the shoulders emerge as the babys head enters the maternal pelvis. The combination of maternal muscle tone and uterine contractions cause the babys head to flex, chin to chest. Then the  back of the babys head emerges and finally the face. Due to the increased pressure during labour and birth, it is normal for the babys leading hip to be bruised and genitalia to be swollen. Babies who assumed the frank breech position in utero may continue to hold their legs in this position for some days after birth. Cesarean or vaginal delivery
When a baby is born bottom first there is more risk that the birth will not be straight forward and that the baby could be harmed. For example, when the babys head passes through the mothers pelvis the umbilical cord can be compressed which prevents delivery of oxygenated blood to the baby. Due to this and other risks, babies in breech position are often born by a planned caesarean section in developed countries.Caesarean section reduces the risk of harm or death for the baby but does increase risk of harm to the mother compared with a vaginal delivery. It is best if the baby is in a head down position so that they can be born vaginally with less risk of harm to both mother and baby.