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Search Results (4)

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Keywords = umbilical cord entanglement

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9 pages, 662 KB  
Article
The Nuchal Cord Conundrum: Understanding and Addressing Umbilical Entanglement in the Third Trimester of Pregnancy
by Julia Murlewska, Sławomir Witkowski, Maria Respondek-Liberska and Iwona Strzelecka
J. Clin. Med. 2024, 13(22), 6836; https://doi.org/10.3390/jcm13226836 - 14 Nov 2024
Viewed by 4874
Abstract
Background/Objectives: Better understanding of and addressing umbilical entanglement in the third trimester of pregnancy is necessary to estimate its impact on fetal circulation. An analysis of single physiological pregnancies wrapped with one or two coils of the umbilical cord around the neck makes [...] Read more.
Background/Objectives: Better understanding of and addressing umbilical entanglement in the third trimester of pregnancy is necessary to estimate its impact on fetal circulation. An analysis of single physiological pregnancies wrapped with one or two coils of the umbilical cord around the neck makes it possible to understand the severity of the problem and distinguish it from perinatal umbilical strangulation. Methods: In an echocardiographic study performed at 32.1 weeks of pregnancy in fetuses with one and two coils of the umbilical cord around the neck, the pulsatility index (PI) and the Tei index for the left (Tei LV) and right ventricle (Tei RV) of the heart were measured to evaluate cardiac function. Results: The study showed significantly higher Tei RV and Tei LV for fetuses with one (93 cases) and two coils of the umbilical cord around the fetal neck (26 cases) with respect to the control group of fetuses (680 cases) with no umbilical cord around the fetal neck, whereas PI UMBA did not differ significantly. Conclusions: Wrapping of the umbilical cord around the fetal neck may affect the study of the fetal heart without any mechanically induced compression of the umbilical vessels in normal pregnancy. Full article
(This article belongs to the Section Obstetrics & Gynecology)
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4 pages, 767 KB  
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Umbilical Cord Wraps around a Newborn’s Legs like Ankle Shackles
by Kun-Long Huang, Ching-Chang Tsai, Hsin-Hsin Cheng, Yun-Ju Lai, Pei-Fang Lee and Te-Yao Hsu
Diagnostics 2024, 14(4), 444; https://doi.org/10.3390/diagnostics14040444 - 17 Feb 2024
Cited by 1 | Viewed by 3991
Abstract
A 36-year-old woman, gravida 3, para 1 (previous cesarean section), with one medical abortion, and no history of systemic diseases presented an unremarkable medical history during prenatal visits. The final prenatal ultrasound at 38 weeks of gestation showed a vertex presentation, a weight [...] Read more.
A 36-year-old woman, gravida 3, para 1 (previous cesarean section), with one medical abortion, and no history of systemic diseases presented an unremarkable medical history during prenatal visits. The final prenatal ultrasound at 38 weeks of gestation showed a vertex presentation, a weight of 2600 g, a normal amniotic fluid level, and the placenta located on the posterior wall of the uterus. Fetal cardiotocography conducted before delivery reported a reactive heart rate without decelerations. The Doppler wave analysis of the fetal umbilical artery was normal (the ratio of peak-systolic flow velocity to the end-diastolic flow velocity was 2.5) without the absence or reversal of end-diastolic velocity. The total score of the fetal biophysical profile by ultrasound was 8. The night before the scheduled cesarean section, she experienced heightened anxiety and was unable to sleep, noting “crazy” fetal movements throughout the night. During the cesarean section, it was discovered that the umbilical cord was wrapped around the newborn’s legs, resembling ankle shackles. The fetal weight was 2740 g, and Apgar scores were 9 at the first minute and 10 at the fifth minute. The motility of the neonatal legs was normal without cyanosis or neurological adverse outcomes. Full article
(This article belongs to the Special Issue Interesting Images in Obstetrics and Gynecology)
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6 pages, 2367 KB  
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Ultrasound Doppler Findings in Fetal Vascular Malperfusion Due to Umbilical Cord Abnormalities: A Pilot Case Predictive for Cerebral Palsy
by Shota Saji, Junichi Hasegawa, Junki Koike, Misato Takatsuki, Natsumi Furuya and Nao Suzuki
Diagnostics 2023, 13(18), 2977; https://doi.org/10.3390/diagnostics13182977 - 18 Sep 2023
Cited by 3 | Viewed by 3723
Abstract
Fetal Vascular Malperfusion (FVM), a pathologic condition in the feto-placental circulation, is a chronic vaso-occlusive disorder in the umbilical venous blood flow. Microthrombi are caused by the umbilical cord’s blood flow deficiency in a congested umbilical vein, which also causes microvascular damage to [...] Read more.
Fetal Vascular Malperfusion (FVM), a pathologic condition in the feto-placental circulation, is a chronic vaso-occlusive disorder in the umbilical venous blood flow. Microthrombi are caused by the umbilical cord’s blood flow deficiency in a congested umbilical vein, which also causes microvascular damage to fetal organs, especially the brain, resulting in cerebral palsy. Thrombo-occlusive events also adversely affect the upstream chorionic or stem vessels in the placenta, resulting in fetal growth restriction and fetal hypoxia. An umbilical cord structural anomaly or multiple entanglements may involve FVM. In the present report, we demonstrate a case of FVM caused by multiple umbilical cord abnormalities obtained from antenatal ultrasound Doppler findings, and we also discuss FVM, which is chronically associated with CP, comparing the ultrasonographic findings to the pathologic findings. Full article
(This article belongs to the Special Issue Fetal Growth Restriction (FGR): Diagnosis and Management)
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23 pages, 8768 KB  
Article
Clinically Relevant Prenatal Ultrasound Diagnosis of Umbilical Cord Pathology
by Roxana Elena Bohîlțea, Vlad Dima, Ioniță Ducu, Ana Maria Iordache, Bianca Margareta Mihai, Octavian Munteanu, Corina Grigoriu, Alina Veduță, Dimitrie Pelinescu-Onciul and Radu Vlădăreanu
Diagnostics 2022, 12(2), 236; https://doi.org/10.3390/diagnostics12020236 - 19 Jan 2022
Cited by 17 | Viewed by 14211
Abstract
Umbilical cord abnormalities are not rare, and are often associated with structural or chromosomal abnormalities, fetal intrauterine growth restriction, and poor pregnancy outcomes; the latter can be a result of prematurity, placentation deficiency or, implicitly, an increased index of cesarean delivery due to [...] Read more.
Umbilical cord abnormalities are not rare, and are often associated with structural or chromosomal abnormalities, fetal intrauterine growth restriction, and poor pregnancy outcomes; the latter can be a result of prematurity, placentation deficiency or, implicitly, an increased index of cesarean delivery due to the presence of fetal distress, higher admission to neonatal intensive care, and increased prenatal mortality rates. Even if the incidence of velamentous insertion, vasa praevia and umbilical knots is low, these pathologies increase the fetal morbidity and mortality prenatally and intrapartum. There is a vast heterogeneity among societies’ guidelines regarding the umbilical cord examination. We consider the mandatory introduction of placental cord insertion examination in the first and second trimester to practice guidelines for fetal ultrasound scans. Moreover, during the mid-trimester scan, we recommend a transvaginal ultrasound and color Doppler assessment of the internal cervical os for low-lying placentas, marginal or velamentous cord insertion, and the evaluation of umbilical cord entanglement between the insertion sites whenever it is incidentally found. Based on the pathological description and the neonatal outcome reported for each entity, we conclude our descriptive review by establishing a new, clinically relevant classification of these umbilical cord anomalies. Full article
(This article belongs to the Special Issue Imaging of Fetal and Maternal Diseases in Pregnancy)
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