Thrombosis of the right umbilical artery, presumably related to the shortness of the umbilical cord: an unusual cause of fetal distress

1983 ◽  
Vol 16 (2) ◽  
pp. 123-127 ◽  
Author(s):  
H. Devlieger ◽  
P. Moerman ◽  
J. Lauweryns ◽  
F. de Prins ◽  
A. van Assche ◽  
...  
Keyword(s):  
Umbilical Cord ◽  
Umbilical Artery ◽  
Fetal Distress ◽  
The Right

scholarly journals Prenatal diagnosis of umbilical artery thrombosis in the second trimester: a case report

2021 ◽  
Vol 29 (1) ◽  
pp. 79-82
Author(s):  
Alev Esercan ◽  
Emre Ekmekci
Keyword(s):  
Prenatal Diagnosis ◽  
Umbilical Cord ◽  
Umbilical Artery ◽  
Rare Condition ◽  
Fetal Distress ◽  
Second Trimester ◽  
Third Trimester ◽  
Intrauterine Growth ◽  
Artery Thrombosis ◽  
Umbilical Cord Cyst

Objective Thrombosis of umbilical artery is a rare condition. The diagnosis is established commonly in the third trimester after detection of fetal distress or intrauterine growth retardation, or could be established after delivery. Also, the management of the condition is conflicting after the diagnosis. Case(s) Here we reported an umbilical artery thrombosis case that was diagnosed in the second trimester after referral for an umbilical cord cyst. After the diagnosis at 24th week of pregnancy, she had been followed up weekly. She had been delivered electively at the 34th week of pregnancy uneventfully. The diagnosis was confirmed postnatally. Conclusion The prenatal diagnosis of umbilical arterial thrombosis is so important to prevent perinatal morbidity. When umbilical cord cysts are detected, further evaluation is required in terms of umbilical artery thrombosis.

scholarly journals FEATURES OF THE COURSE OF THE PERINATAL PERIOD AND DELIVERIESDURING PREGNANCY WITH A SINGLE UMBILICAL ARTERY OF THE FETUS

2019 ◽  
pp. 28-35
Author(s):  
O. V. Krasovskaya ◽  
V. P. Lakatosh ◽  
O. V. Ivashchenko ◽  
I. V. Guzhevskaya
Keyword(s):  
Pregnant Women ◽  
Umbilical Cord ◽  
Neurological Disorders ◽  
Umbilical Artery ◽  
Fetal Distress ◽  
Study Groups ◽  
Perinatal Period ◽  
Control Group ◽  
Fetal Hypoxia ◽  
And Control

Among the anomalies in the number of vessels of the umbilical cord,thesingle umbilical artery (SUA) is most often found. A significant impact of SUA on the course of such pregnancy and deliveries is expected. The article presents some peculiarities of the deliveries and condition of newborns after pregnancies with SUA compared with pregnant women with three umbilical cord vessels and physiological deliveries. The objective of the workwasto analyze the peculiarities of the perinatal period and deliveries after pregnancy with SUA, to conduct a comparative analysis of the revealed features with the corresponding indicators among pregnant women with two umbilical arteries and physiological births. Thestudygroupconsistedof 31 pregnant women with a SUA (study group)and control group – 62 pregnant women with 2 arteries of the umbilical cord. According to our data, pregnant womenwith SUA were hospitalized earlier and spent more time in the maternity hospital, although the terms of delivery did not differ between the two study groups, although there was a tendency to an earlier term of delivery in pregnant women with SUA. Among pregnant women with SUA, deliveries were premature in 4 women (12.9 %). No differences were found between pregnant women with SUA and control group in such indicators as early discharge of amniotic fluid, anthropometric indicators of pregnant women, entanglement of umbilical cord, pelvic presentation, rupture of the perineum or episiotomy during deliveries. The duration ofI, II and III periods of deliveries also did not differ significantly between the two study groups. Weakness of patrimonial activity was more often in women with SUA, accounting for 12.9 % of all deliveries, compared to 3.2 % in the control group. Fetal hypoxia in deliveries was observed in 25.8 % of cases among pregnant women with SUA, and in 4.8 % among pregnant women in the control group. Fetal distress in deliveries was estimated at 4 (12.9 %) and 4 caesarean sections were performed. Physiological childbirth occurred in all cases in the control group. In the SUA group, the infant weight was significantly lower than the control group children, but the Apgar score at 1 and 5 minutes did not differ between the two study groups. Cardio-respiratory depression, risk of neurological disorders, and congenital malformations (esophageal atresia, Gothic palate, and syndactylium) were more frequently reported in the SUA group. Long-term hospitalization of pregnant women, weakness in delivery, premature birth, fetal hypoxia in delivery, fetal distress and incidence of cesarean delivery are much more common in SUA group. The weight of newborns from pregnancies with SUA is significantly lower, however, the infants' status on the Agar scale after pregnancies with SUA did not differ from those of children in the control group. Cardiovascular depression, the risk of neurological disorders, and congenital malformations (esophageal atresia, Gothic palate, and syndactyly) were more common in the SUA group.

Massive Extra-Abdominal Umbilical Vein Varix: A Case Report

2021 ◽  
pp. 1-4
Author(s):  
Josef Jackson ◽  
Eumenia Castro ◽  
Michael A. Belfort ◽  
Alireza A. Shamsirshaz ◽  
Ahmed A. Nassr ◽  
...  
Keyword(s):  
Case Report ◽  
Umbilical Cord ◽  
Neonatal Period ◽  
Umbilical Vein ◽  
Fetal Distress ◽  
Fetal Anemia ◽  
Pathologic Examination ◽  
Fetal Demise ◽  
Increased Risk ◽  
Umbilical Vein Varix

Umbilical vein varices are rare umbilical cord anomalies that typically occur intra-abdominally. Extra-abdominal umbilical vein varices are exceedingly rare and usually diagnosed postnatally on gross pathologic examination. Umbilical vein varices have been associated with increased risk of fetal anemia, cardiac abnormalities, and intrauterine fetal demise. This case report discusses a patient who presented with a massive extra-abdominal umbilical vein varix, whose infant was ultimately delivered due to fetal distress and died in the neonatal period. This report also discusses associated fetal conditions and guidelines for antenatal testing and surveillance of known umbilical vein varices.

Element content of human umbilical artery and vein in umbilical cord

1999 ◽  
Vol 69 (3) ◽  
pp. 235-240 ◽  
Author(s):  
Mitsuhiko Masuda ◽  
Setsuko Tohno ◽  
Yoshiyuki Tohno ◽  
Takeshi Minami ◽  
Yumi Moriwake ◽  
...  
Keyword(s):  
Umbilical Cord ◽  
Umbilical Artery ◽  
Element Content ◽  
Human Umbilical Artery

scholarly journals Direction of Umbilical Cord Twist and its Characteristics – a Pilot Study

2013 ◽  
Vol 1 (3) ◽  
pp. 120-122
Author(s):  
Althea V. Pinto ◽  
Alex X. Chakiath ◽  
Prudhvi Dasari ◽  
Vilekith Reddy ◽  
Shirley George ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Umbilical Cord ◽  
Umbilical Artery ◽  
Study Data ◽  
Placenta Praevia ◽  
Single Umbilical Artery ◽  
Chi Square ◽  
Live Births ◽  
Chi Square Test ◽  
Umbilical Cords

Background: A right-sided umbilical cord twist is associated with the presence of a single umbilical artery, congenital malformations and placenta praevia. Methods: It was an observational study. Data was collected from 137 umbilical cords, all from live births and their patient records. The gestational ages ranged from 28 weeks to 41 weeks. The umbilical cords were categorized into right or left, based on the direction of twist. The independent sample T test and the Chi square test were used to analyze the differences between groups. Results: The prevalence of left twist was 84%. Right twist was significantly associated with a larger Hyrtl’s anastomosis (p=0.029) and gestational diabetes (p=0.027). Conclusion: Two previously unreported associations with right twist of the umbilical cord, gestational diabetes and an increase in the diameter of Hyrtl’s anastomosis, were noted in the present study.

scholarly journals THE CORRELATION OF ARTERIAL CORD BLOOD GAS VALUES AND APGAR SCORES IN TERM BABIES WITHOUT FETAL DISTRESS AND THEIR EFFECTS ON NICU ADMISSIONS

2021 ◽  
Author(s):  
ASLAN YILMAZ ◽  
Nesrin Kaya ◽  
Ipek Ulkersoy ◽  
Zeynep Alp Ünkar ◽  
Hazal Cansu ACAR ◽  
...  
Keyword(s):  
Cord Blood ◽  
Neonatal Intensive Care ◽  
Umbilical Artery ◽  
Fetal Distress ◽  
Well Being ◽  
Blood Gas ◽  
Threshold Values ◽  
Apgar Scores ◽  
Nicu Admission ◽  
Two Parameters

Abstract Background Umbilical artery cord blood gas (UACG) values and Apgar scores (AS) are the two parameters that provide the fastest information about the well-being of a baby after birth. We hypothesized that AS may not be sufficient for a complete and correct evaluation of the newborns and UACG should be used routinely for all births even without any signs of fetal distress. Material-methods In this retrospective study, the data of 1781 babies born between January 2018 and December 2019 at Cerrahpasa Faculty of Medicine were analyzed. Newborn with fetal distress, congenital anomalies, severe and moderate acidemia (pH ≤7.1 at UACG), and pre and postterm newborns are excluded. The UACG and the 1 and 5-minute AS data of 1438 cases were evaluated. Mild acidemia was accepted as a pH between 7.1 and 7.2. Following UACG threshold values were accepted as abnormal pH <7.2, BE <-6 mmol/l, lactate ≥5 mmol/l, HCO3 <18 mmol/l, pCO2 ≥50 mmHg. We evaluated the correlation between UACG and 1 and 5-minute AS and their effects on admission to neonatal intensive care unit (NICU). Results There was a significant correlation between both 1 and 5-minute AS and UACG values such as pH, lactate, and pCO 2 (p<0.001). In addition, significant correlation was found between the 5-minute AS below 7 and some UACG abnormal threshold values (pH, HCO 3 , base excess) (p<0.001). We found that some cases with mild acidemia had a normal 1 and 5-minute Apgar scores (AS≥7) in %1.9 and %2 of cases, respectively. A significant correlation was found between admissions to NICU with 1 and 5-minute AS of <7 (p<0.001). Conclusions The 5-minute AS of 7 or higher may not be sufficient to verify the well-being of a newborn. Relying only on AS, may create the risk of missing some newborns with mild metabolic acidosis. 1 and 5-minute AS could be used as a predictive value for NICU admission. We propose that routine UACG should be evaluated for each birth at term, even without any signs of fetal distress and normal AS.

Can the difference of Doppler indexes at the different points of the umbilical artery predict to the umbilical cord length?

2018 ◽  
Vol 33 (5) ◽  
pp. 847-851
Author(s):  
Esra Bahar Gur ◽  
Ebru Sahin Gulec ◽  
Serpil Aydogmus ◽  
Mehmet Serkan Gur ◽  
Elif Yazici Tekeli ◽  
...  
Keyword(s):  
Umbilical Cord ◽  
Umbilical Artery ◽  
The Difference ◽  
Cord Length

Abstract 11740: Fetal and Neonatal Markers of Neurodevelopmental Outcome in Congenital Heart Disease

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Ismee A Williams ◽  
Howard Andrews ◽  
Michael M Myers ◽  
William Fifer
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Infant Development ◽  
Umbilical Artery ◽  
Neurodevelopmental Outcome ◽  
Abdominal Circumference ◽  
Temporal Region ◽  
Z Score ◽  
The Right

Objectives: Children with congenital heart disease (CHD) are at risk for abnormal neurodevelopment (ND). We evaluated associations between fetal Doppler and biometry measures, neonatal electroencephalogram (EEG) and 18-month ND. Methods: Fetuses with hypoplastic left heart syndrome (HLHS), transposition of the great arteries (TGA), and tetralogy of Fallot (TOF) had middle cerebral (MCA) and umbilical artery (UA) Doppler velocities, as well as biometry such as head (HC) and abdominal circumference (AC), prospectively recorded at 20-25 (F1), 26-32 (F2), and 33-39 (F3) wks gestational age (GA). Pulsatility indices (PI) with GA-derived z-scores and cerebral-to-placental resistance (CPR) ratios were calculated. Neonatal high-density EEG was preformed preoperatively and the Bayley Scales of Infant Development-III were assessed at 18-months. Factor analysis was used to reduce the number of EEG predictors used in regression analysis. Results: Among 56 CHD fetuses (N=19 HLHS, N=16 TGA, N=21 TOF) who underwent preoperative EEG, ND scores are available for 33 to date. Cardiac subtype was highly associated with EEG and was considered in all models. Cognition scores were predicted by CPR< 1 ever (B=-15.7, P=0.002) and HC/AC at F2 (B=-130, P=0.013, R 2 =0.42). Language scores were predicted by UA PI z-score at F1 (B=-9.6, P=0.005, R 2 =0.27). Motor scores were predicted by UA PI z-score at F1 (B=-3.9, P=0.085), HLHS (B=-15, P<0.001), EFW%ile (B=0.374, P=0.007), and delta band right parietal and right temporal log power in active sleep (B=3.9, P=0.045, R 2 =0.61). Conclusion: Lower umbilical artery pulsatility at 20-25 wks GA was associated with higher 18-month Language and Motor scores. A diagnosis of HLHS predicted poorer Motor scores. Increased EEG power in the parietal and temporal region of the right brain predicted higher Motor scores. A larger abdomen relative to head at 26-32 wks was associated with improved cognition while diminished cerebrovascular compared with placental resistance predicted poorer cognition, similar to what has been observed in the growth restricted fetus. Further investigation is needed to confirm these hypothesis-generating findings.

Blood Pressure and Pulse Rate in the Foetal Sheep

1945 ◽  
Vol 22 (1-2) ◽  
pp. 63-74
Author(s):  
JOSEPH BARCROFT ◽  
D. H. BARRON
Keyword(s):  
Blood Pressure ◽  
Central Nervous System ◽  
Nervous System ◽  
Pulse Rate ◽  
Umbilical Artery ◽  
The Central Nervous System ◽  
The Right ◽  
First Moment ◽  
Left Vagus ◽  
Stimulation Of

1. A method (the needle method) is described for the measurement of the pressure in the stream going through a vessel. 2. In the foetal sheep the needle method applied to the umbilical artery gives substantially the same results as the mercurial manometer applied to the carotid, until about half-way through the gestation period. 3. As gestation proceeds the needle method applied at the first moment at which it can be applied to the umbilical artery (or a branch) gives readings substantially lower, and increasingly lower as gestation proceeds, than does the mercurial manometer read at the first moment at which it can be read. 4. The discrepancy is due to the sum of a number of causes which are discussed, but of these the most important is an actual rise of pressure between the time of delivery and the completion of the dissections contingent on the use of the mercurial manometer. 5. The cause of this is not at present demonstrated, but either or both of two factors may be concerned: (a) a dulling of the central nervous system which weakens the depressor reflex; (b) the establishment of a greater degree of vasomotor tone consequent on the bombardment of the central nervous system with sensory stimuli. 6. The pulse rates in utero and just after delivery of the foetus into a saline bath at 39-40°C. (the umbilical circulation being unimpaired) are not significantly different. 7. The pulse rate quickens up to the 70th-80th day, after which it becomes slower as gestation proceeds. 8. If both vagi be severed, the pulse rate te to quicken throughout gestation. The pulse, therefore, comes increasingly under vagus inhibition from the 80th-90th day onwards. 9. Even after the vagi have been cut after the 120th day (it has not been tried before) adrenalin in sufficient quantity will cause a further quickening of the pulse. 10. The earliest date at which stimulation of the peripheral end of the right vagus was observed to slow the heart was the 77th day. On the 85th day peripheral stimulation of the left vagus also failed, but succeeded on the 101st day. 11. Central stimulation of the left vagus, with the right vagus intact, produced slowing on the 77th day. 12. Slowing of the heart synchronous with rise of arterial pressure has been observed on the 111th day. 13. Slowing of the heart which bears evidence of being reflex has been obtained by raising the blood pressure (clamping the cord) on the 121st day and by injection of adrenalin on the 118th day. 14. Approaching term both the carotid sinus and cardiac depressor mechanisms are functional. 15. Lowering of the blood pressure as the result of stimulation of the central end of the vagus and with both vagi severed can be demonstrated late in gestation.

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