scholarly journals Case Report: Pre- and postnatal management of an allantoic cyst with patent urachus and single umbilical artery

F1000Research ◽  
2015 ◽  
Vol 4 ◽  
pp. 124 ◽  
Author(s):  
Than Trong Thach ◽  
Vo Duy Quan ◽  
Tran Diem Nghi ◽  
Nguyen Hoang Anh ◽  
Le Phi Hung ◽  
...  
Keyword(s):  
Umbilical Cord ◽  
Umbilical Artery ◽  
Male Infant ◽  
Cystic Mass ◽  
Ultrasound Images ◽  
Close Monitoring ◽  
Single Umbilical Artery ◽  
Patent Urachus ◽  
Ultrasound Assessment ◽  
Open Surgical Approach

Patent urachus is a rare congenital abnormality. Since its first description by Cabriolus in 1550, few cases have been reported. A 26-year-old Vietnamese primigravida presented at 20 weeks of gestation for evaluation of a cystic mass in the umbilical cord, which was first discovered at week 13 of pregnancy by ultrasound scan. The cystic mass originated from the root of the umbilical cord, connected to the urinary bladder, and no intestinal contents were enclosed within. Doppler ultrasound assessment showed that the single umbilical artery existed within the normal range. The progression of the umbilical cyst continued to be screened, but the mass disappeared on ultrasound images at 27 weeks of gestation. This led to the consideration of the cyst’s rupture. After 38 gestational weeks, the pregnant woman delivered a 3350g male infant via cesarean section because of an obstructed vaginal labor. The following days, a stream of urine was recorded leaking out from the umbilical mass whenever he cried. Seven weeks after delivery, an open surgical approach was successfully performed. The baby is now 43 months of age, growing and developing normally. Since an allantoic cyst with patent urachus is a rare clinical entity, early discovery, close monitoring and accurate diagnosis through ultrasound in the prenatal period may consequently allow clinicians to have suitable attitudes towards management when the infant is born.

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 To Estimate the Importance of Wharton’s Jelly in the Growth of the Foetus – A Light Microscopic Study

2021 ◽  
Vol 10 (35) ◽  
pp. 3024-3029
Author(s):  
Sreekumar Rajasekharan ◽  
UmesanKannanvilakom Govindapillai ◽  
Manju Madhavan C. ◽  
Suja R. S. ◽  
Swapna T ◽  
...  
Keyword(s):  
Umbilical Cord ◽  
Wall Thickness ◽  
Umbilical Artery ◽  
Umbilical Vein ◽  
Wharton’S Jelly ◽  
External Diameter ◽  
Single Umbilical Artery ◽  
Wharton's Jelly ◽  
Significant Difference ◽  
The Mean

BACKGROUND Human umbilical cord contains two arteries and one vein with their tunica intima and tunica media layers. The role of tunica adventitia is fulfilled by Wharton’s jelly, a mucoid connective tissue. The function of Wharton’s jelly is to prevent the vessels from compression and torsion which is essential for foetal development. The purpose of the study was to estimate the importance of Wharton’s jelly in the growth of the foetus. METHODS Umbilical cord tissue collected from each case was immediately put in 10 % formalin for fixation. Slides were then stained with Haematoxylin and Eosin. These slides were then read under light microscopy and measurements were taken using a photomicrograph. Wharton’s jelly area was calculated by subtracting the total vessel area from the umbilical cord area. RESULTS The histological measurements of umbilical vessels include the external diameter, lumen diameter, wall thickness, thickness of tunica intima and tunica media, and the area. The mean area of the umbilical cord was 35.73 ±23.04 mm2 (Mean ± SD) and the mean area of the Wharton’s jelly was 29.74 ± 19.26 mm2. There was a significant difference in the external diameter and wall thickness of the umbilical artery. Analyses showed that there was a significantly (P < 0.01) increased external diameter and wall thickness of umbilical artery in normal cases, compared to single umbilical artery cases. CONCLUSIONS There was a significant positive correlation between the gestational age and the external diameter of the umbilical cord. There was a significant difference in the external diameter of the umbilical cord between SUA cases (4.45 mm) and the other foetuses with normal umbilical cord (6.53 mm). There was a significantly increased external diameter, lumen diameter, wall thickness and area of umbilical vein in normal cases, compared to single umbilical artery cases. There was a significantly increased area of umbilical cord and area of Wharton’s jelly in normal umbilical cord foetuses than foetuses with a single umbilical artery. KEY WORDS Foetus, Umbilical Cord, Wharton’s Jelly, Umbilical Artery, Umbilical Vein, Light Microscopy

Prenatal ultrasound diagnosis of umbilical artery aneurysm with favorable outcome

2018 ◽  
Author(s):  
Yu.V. Shatokha
Keyword(s):  
Prenatal Diagnosis ◽  
Umbilical Cord ◽  
Umbilical Artery ◽  
Chromosomal Abnormalities ◽  
Ultrasound Examination ◽  
Artery Aneurysm ◽  
Prenatal Ultrasound ◽  
Ultrasound Diagnosis ◽  
Colour Doppler ◽  
Single Umbilical Artery

The case of prenatal ultrasound diagnosis of single umbilical artery aneurysm is presented. During ultrasound examination at 21 weeks of gestation several anomalies in the umbilical cord were detected: the umbilical right artery was missing and dilatation of the umbilical artery with a diameter 10 mm close to fetus. With colour Doppler and pulsed Doppler was demonstrated arterial turbulent flow in the aneurysm. Prenatal diagnosis of the single umbilical artery aneurysm was made. Other fetal measurements were normal. The diameter of the aneurysm increased throughout the pregnancy till 16 mm at 33 weeks of gestation. Cesarean section was performed at 34 weeks with baby weight 2150 g. The post-delivery examination of the umbilical cord confirmed the prenatal diagnosis. No chromosomal abnormalities were found. After six months the baby is alive and well.

Letters to the Editor

PEDIATRICS ◽  
1973 ◽  
Vol 52 (6) ◽  
pp. 890-891
Author(s):  
Luz A. Froehlich
Keyword(s):  
Umbilical Cord ◽  
Umbilical Artery ◽  
Standard Protocol ◽  
Letters To The Editor ◽  
Single Umbilical Artery

Dr. Froehlich commented as follows: With regard to the method of examination of the cord, we wish to reassure Dr. Van Leeuwen that all the examinations were done by pathologists. Based on the "name of examiner" indicated on the standard protocol, it can be clearly stated that the examinations were done in the vast majority of instances by the project pathologist himself or under his supervision. In addition, the protocol required that when a single umbilical artery was initially noted on bisecting the mid-portion of the cord, the rest of the umbilical cord throughout its length was to be examined at one-inch intervals.

Velamentous cord insertion ruptured during labour leading to acute fetal blood loss

2021 ◽  
Vol 14 (4) ◽  
pp. e240245
Author(s):  
Takeshi Nagao ◽  
Erisa Kuriyama ◽  
Ami Sato ◽  
Michiko Yamanaka
Keyword(s):  
Umbilical Cord ◽  
Umbilical Artery ◽  
Fetal Heart ◽  
Male Infant ◽  
Fetal Survival ◽  
Arterial Blood ◽  
Blood Ph ◽  
Rapid Drop ◽  
Prompt Diagnosis ◽  
Velamentous Cord Insertion

Umbilical cord rupture (UCR) in utero is a very rare and critical emergency that can cause fetal death within minutes. A 38-year-old nulliparous woman was admitted at 39 weeks in labour. Sudden watery vaginal discharge and bleeding with a rapid drop in the fetal heart rate to 60 beats/min necessitated an emergency caesarean section. A male infant weighing 2632 g was delivered 21 min after the onset of bradycardia; Apgar scores were 0 and 1 at 1 and 5 min, respectively. He was extremely pale; the umbilical arterial blood pH was 6.89 and haemoglobin was 9.0 g/dL. The umbilical cord had a velamentous insertion and was lacerated, with haemorrhage in the outer layer of an umbilical artery close to the placental end. The presentation was typical of UCR: vaginal bleeding following the rupture of membranes. Prompt diagnosis of UCR and termination of pregnancy are essential for fetal survival.

scholarly journals A case of prenatal diagnosis of single umbilical artery due to thrombosis diagnosed by the ultrasound finding of “wink-sign”

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Minako Goto ◽  
Masamitsu Nakamura ◽  
Tatsuya Arakaki ◽  
Hiroko Takita ◽  
Ryu Matsuoka ◽  
...  
Keyword(s):  
Prenatal Diagnosis ◽  
Umbilical Cord ◽  
Umbilical Artery ◽  
Antenatal Diagnosis ◽  
Ultrasound Finding ◽  
Single Umbilical Artery ◽  
Case Presentation ◽  
Artery Thrombosis ◽  
Antenatal Management ◽  
Adverse Pregnancy

AbstractObjectivesUmbilical artery thrombosis is a significant umbilical cord condition that is associated with adverse pregnancy outcomes. However, no consensus has been reached regarding how umbilical artery thrombosis should be diagnosed or managed because of its rarity and the difficulty associated with an antenatal diagnosis.Case presentationHere, we describe a case involving decreased fetal movement and non-reassuring fetal status (NRFS) in which acute umbilical artery thrombosis was prenatally diagnosed. Transabdominal ultrasound showed that the cross-section of the umbilical cord had one normal artery and a small deformed echogenic area. A characteristic ultrasound finding known as the “wink sign” contributed to the prenatal diagnosis.ConclusionsEvaluation of the umbilical cord enabled the estimation and facilitated the subsequent antenatal management.

Anatomical Pathology of the Umbilical Cord and Its Maternal and Fetal Clinical Associations in 434 Newborns

2018 ◽  
Vol 21 (5) ◽  
pp. 467-474 ◽  
Author(s):  
Mercedes Olaya-C ◽  
Fabian Gil ◽  
Juan D Salcedo ◽  
Ana J Salazar ◽  
Jaime L Silva ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Umbilical Cord ◽  
Umbilical Artery ◽  
Single Umbilical Artery ◽  
Factors Associated ◽  
Ordered Logistic Regression ◽  
Fetal Complications ◽  
Clinical Associations ◽  
The Relationship ◽  
Anatomical Pathology

Introduction Umbilical cord (UC) abnormalities and their clinical relations in 434 newborns were analyzed. We had previously reported on clinical associations of long and short UCs with any kind of malformation. This study focuses on other UC features (insertion, vessels, entanglements, coiling, and knots) and their associations with clinical characteristics and neonatal prognosis. Methods An observational analytic study was performed on placentas from consecutive deliveries. Ordered logistic regression with bivariate and multivariate analysis was performed to evaluate the relationship between variables of interest concerning UC abnormalities. Results A total of 434 placentas made up the study. UC abnormalities were abnormal insertion, 82 (18.86%); coiling (hypo and hypercoiled), 177 (40.78%); single umbilical artery (SUA), 4 (0.92%); entanglements, 8 (1.84%); true knots, 3 (0.69%); webs in UC base, 9 (2.07%); and right twist, 68 (15.67%). After analyzing maternal and fetal complications during pregnancy, multivariate analysis confirmed the recognized association between malformations and SUA and male gender; further confirmation was also made between hypertensive disorders of pregnancy and true knots. Discussion UC abnormalities associated with undesirable outcomes are varied and should be recognized and described. Clinical factors associated with anatomical UC abnormalities are not completely understood and justify forthcoming studies.

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