Herniation of the appendix into the umbilical cord complicating umbilical vessel cannulation

There is an increasing interest in the physiology and pathology of the umbilical cord because it is recognized as an important source of placental and, consequently, fetal problems. During the postmortem examination of a severely macerated 13-week-old fetus, a split umbilical cord was noted. This rare finding was seen in the middle segment of the cord, the fetal and placental ends both being normal. The pathogenesis of this lesion is not fully understood, and it is possible that it results through focal degeneration of previously formed Wharton's jelly or secondary loss of Wharton's jelly due to incomplete fusion or hypoplasia of the amniotic covering. Whatever the pathogenesis, it is assumed that an umbilical vessel devoid of its protective Wharton's jelly is more prone to compression and thrombosis with all its deleterious effects. Death in this case was probably associated with the congenital heart defect also presented by the fetus. The rarity of this lesion is probably explained by the fact that it represents the end of the spectrum of longitudinal deficiency of Wharton's jelly, a relatively common finding.

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Heterotopic Liver Nodule Compressing a Two-Vessel Umbilical Cord: An Unusual Cause of Intrauterine Fetal Demise

Pediatric and Developmental Pathology ◽

10.1177/1093526621993330 ◽

2021 ◽

pp. 109352662199333

Author(s):

Chrystalle Katte Carreon ◽

Juan Putra ◽

Sara O Vargas

Keyword(s):

Umbilical Cord ◽

Liver Tissue ◽

In Utero ◽

Fetal Demise ◽

Umbilical Vessel ◽

Intrauterine Fetal Demise ◽

Nodular Tissue

Heterotopic liver tissue in the umbilical cord is rare, and the outcome is quite unpredictable based on the few reported cases. We present a case of heterotopic liver nodule in the umbilical cord of a midtrimester fetus who died in utero. Although such association has only been reported once, heterotopic nodular tissue in the umbilical cord must be regarded as a potential cause of fetal demise by a mechanism analogous to the more common umbilical cord abnormalities resulting in umbilical vessel compromise.

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Sonographic umbilical vessel morphometry and perinatal outcome of fetuses with a lean umbilical cord

Journal of Clinical Ultrasound ◽

10.1002/jcu.20076 ◽

2004 ◽

Vol 33 (1) ◽

pp. 18-23 ◽

Cited By ~ 17

Author(s):

Fabio Ghezzi ◽

Luigi Raio ◽

Daniela Günter Duwe ◽

Antonella Cromi ◽

Evgenia Karousou ◽

...

Keyword(s):

Umbilical Cord ◽

Perinatal Outcome ◽

Umbilical Vessel

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Furcate insertion of the umbilical cord: pathological and clinical characteristics in 132 cases

Journal of Perinatal Medicine ◽

10.1515/jpm-2019-0459 ◽

2020 ◽

Vol 48 (8) ◽

pp. 819-824

Author(s):

Philipp Kosian ◽

Wolfgang Henrich ◽

Michael Entezami ◽

Alexander Weichert

Keyword(s):

Retrospective Study ◽

Umbilical Cord ◽

Perinatal Outcome ◽

Clinical Characteristics ◽

Fetal Death ◽

University Hospital ◽

Intrauterine Fetal Death ◽

Pathological Characteristics ◽

Umbilical Vessel ◽

Vessel Rupture

AbstractObjectivesFurcate cord insertion is a rare abnormality affecting approximately 0.1% of all pregnancies. Macroscopically, the umbilical vessels separate before reaching the placenta, lose their Wharton’s jelly, and insert at the placenta centrally, eccentrically, or marginally. The aim of this retrospective study was to determine the prevalence of furcate cord insertion more accurately, the pathological characteristics, and clinical outcomes.MethodsWe conducted a retrospective study of 132 cases of furcate insertion of the umbilical cord using the pathological database of the Charité University Hospital Berlin, Germany, between 1993 and 2016. This included 99 cases, including one termination of pregnancy within our institution and 33 cases from external hospitals. An analysis of the pathological features of the 132 cases and the perinatal outcome of the 98 cases within our institution were performed.ResultsFurcate cord insertion occurred in 0.16% pregnancies. Of the 132 cases, seven cases of intrauterine fetal deaths were observed. Three of those could be linked to the furcate cord insertion. In two of those cases, single umbilical vessel rupture was identified as the cause of fetal death.ConclusionsIn most cases of furcate cord insertion, the outcome is good; however, intrauterine fetal death occurs in approximately 1.02% of cases.

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Ultrastructure of the Omphalomesenteric Duct Rest in the Umbilical Cord at Term

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100053917 ◽

1982 ◽

Vol 40 ◽

pp. 250-251

Author(s):

B. A. Clark ◽

T. Okagaki

Keyword(s):

Umbilical Cord ◽

Umbilical Vein ◽

Meckel’S Diverticulum ◽

Meckel's Diverticulum ◽

Columnar Epithelium ◽

Omphalomesenteric Duct ◽

Umbilical Arteries

Vestiges of the omphalomesenteric or vitello-intestinal duct and the pathologic implications attributed to these remnants have been treated in great detail by several investigators. Persistence of the omphalomesenteric duct is associated with such conditions as Meckel's diverticulum, umbilical fistula, mucosal polyps, and sinuses or cysts of the umbilicus. Remnants of the duct in the umbilical cord, although infrequent, are located outside of the triangle formed by the two umbilical arteries and the umbilical vein, are usually discontinuous and are often represented by a small lumen lined by cuboidal or columnar epithelium. This study will examine the ultrastructure of these cells.

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