Prenatal detection and obstetric management of true umbilical cord knots using color Doppler and 4D ultrasonography: a report of two cases and literature review

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Ayse Filiz Gokmen Karasu ◽  
Mehmet Serdar Kutuk
Keyword(s):  
Umbilical Cord ◽  
Antenatal Diagnosis ◽  
Color Doppler ◽  
First Trimester ◽  
Case Presentation ◽  
Increased Risk ◽  
Technology Applications ◽  
Trimester Screening ◽  
Obstetric Management ◽  
Route Of Delivery

Abstract Background True umbilical cord knots are common incidental findings at birth, however, there are limited reports of antenatal diagnosis. True knots are mostly asymptomatic; however, cord related accidents may be encountered. Case presentation We present two cases we diagnosed and followed-up antenatally. We reviewed previous literature and found 16 reports of antenatal diagnosis. In addition to foregoing established risk factors, we noticed an increased risk at first trimester screening in our cases. Conclusions Modern ultrasonography (USG) technology applications are valuable for monitoring knot architecture and compression. We propose monitoring the baby with daily kick counts and biweekly cardiotocography after 28–30 weeks of gestation. Weekly umbilical Doppler pulsatility (PI) measurements of afferent and efferent loops with respect to the gestational age, aids in monitoring the tightness of the knot. The timing and route of delivery should be necessitated by obstetric indications. Vaginal delivery is possible under continuous fetal monitorization during labor.

scholarly journals First trimester diagnosis of body stalk anomaly complicated by ectopia cordis

2020 ◽  
Vol 48 (12) ◽  
pp. 030006052098021
Author(s):  
Yi Yang ◽  
Hong Wang ◽  
Zhenpeng Wang ◽  
Xuefeng Pan ◽  
Ying Chen
Keyword(s):  
Abdominal Wall ◽  
Umbilical Cord ◽  
Chromosomal Abnormalities ◽  
Abdominal Wall Defect ◽  
First Trimester ◽  
Nuchal Translucency ◽  
Ectopia Cordis ◽  
Wall Defect ◽  
Abdominal Organs ◽  
Increased Risk

Body stalk anomaly is a rare abnormality characterized by an abdominal wall defect with evisceration of abdominal organs, severe kyphoscoliosis, and a very short or absent umbilical cord. Ectopia cordis (EC) is a rare, lethal anomaly characterized by complete or partial malpositioning of the heart outside of the thorax. A 28-year-old healthy primigravida was referred to our department to undergo a nuchal translucency thickness scan at 12 weeks’ gestation. The scan revealed typical features of body stalk anomaly and EC. Given the lethal condition of the fetus, the patient opted for termination of the pregnancy. Body stalk anomalies, especially those complicated by EC, are universally lethal for the affected fetus. Selective termination should be recommended to avoid possible complications that can arise during pregnancy. Additionally, the future parents should be informed that because the condition is not associated with chromosomal abnormalities, there is no increased risk of recurrence.

Non-compacted myocardium and foetal left isomerism as a hydrops’ aetiology

2010 ◽  
Vol 20 (2) ◽  
pp. 223-225 ◽  
Author(s):  
Ilda J. G. Rocha ◽  
Rosete M. A. N. Nogueira ◽  
Ana L. C. Carriço
Keyword(s):  
Case Report ◽  
Trisomy 21 ◽  
Septal Defect ◽  
First Trimester ◽  
First Trimester Screening ◽  
Cardiac Malformation ◽  
Foetal Death ◽  
Left Isomerism ◽  
Increased Risk ◽  
Trimester Screening

AbstractWe present a case report of a pregnant woman with increased risk for trisomy 21 at first-trimester screening, assessed by ultrasonography, that was sent to our hospital. Amniocentesis was performed at 14 weeks and 2 days to obtain foetal karyotype that was normal (46,XX). At 19 weeks and 1 day, foetal hydrops associated with cardiac malformation was detected by routine scan. Foetal echocardiogram revealed a complete auriculoventricular septal defect, non-compacted myocardium, and a bradycardia of 70–90 beats per minute, which lead to the suspicion of left isomerism. Foetal death occurred at 20 weeks and 3 days. Autopsy was consistent with the prenatal diagnosis.

Low Fetal Fraction and Birth Weight in Women with Negative First-Trimester Cell-Free DNA Screening

2019 ◽  
Vol 37 (01) ◽  
pp. 086-091
Author(s):  
Mark A. Clapp ◽  
Margaret Berry ◽  
Lydia L. Shook ◽  
Penelope S. Roberts ◽  
Ilona T. Goldfarb ◽  
...  
Keyword(s):  
Birth Weight ◽  
First Trimester ◽  
Cell Free Dna ◽  
Free Dna ◽  
Increased Risk ◽  
Trimester Screening ◽  
Future Work ◽  
Primary Variable ◽  
Cfdna Screening ◽  
Fetal Fraction

Abstract Objective To determine the association between low fetal fraction and birth weight among women with a negative cell-free DNA (cfDNA) result for common aneuploidies in the first trimester. Study Design This is a retrospective cohort of women who delivered a singleton between July 2016 and June 2018 at a single institution and had normal cfDNA testing in the first trimester. The primary variable of interest was “low fetal fraction,” which was defined as fetal fractions less than 5th percentile among all fetal fractions in the cohort (fetal fraction < 5.34%). The primary outcomes were birth weight ≤ 5th and ≤ 10th percentiles. Multivariable logistic regressions assessed for the association between low fetal fraction and birth weight. Results A total of 7,478 women delivered a singleton at ≥24 weeks' gestation, of which 2,387 (32%) underwent genetic screening through cfDNA; the majority were in the first trimester (n = 2,052 [86%]). 2,035 met the inclusion criteria. Birth weight ≤ 5th percentile was significantly higher in the low fetal fraction group (6.9 vs. 3.2%; p = 0.04). A low fetal fraction was associated with higher odds of an infant with a low birth weight: adjusted odds ratio (aOR) of 2.32 (95% CI 1.15–4.67) for birth weight ≤ 10th percentile (p = 0.02) and aOR of 3.73 (95% CI 1.40–9.03) for birth weight ≤ 5th percentile (p = 0.004). Conclusion Low fetal fractions of ≤ 5th percentile were associated with an increased risk of birth weights ≤ 5th and ≤ 10th percentiles in women with negative cfDNA screening in the first trimester. Future work is needed to further investigate this relationship and to determine the potential clinical implications, such as third-trimester screening for growth restriction in women with low fetal fractions and negative cfDNA screening results.

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.

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