scholarly journals Evaluation of Sonographic Measurement of Umbilical Cord Coiling Index in the Second Trimester and Its Correlation to Perinatal Outcome

2021 ◽  
Vol 5 (05) ◽  
pp. 01-07
Author(s):  
Naglaa Ali M. Hussein ◽  
Mohammed H. El Refaey
Keyword(s):  
Antenatal Care ◽  
Umbilical Cord ◽  
Fetal Growth ◽  
Apgar Score ◽  
Fetal Death ◽  
Perinatal Outcomes ◽  
Fetal Distress ◽  
Intrauterine Fetal Death ◽  
Ultrasound Scan ◽  
Umbilical Cords

The umbilical cord represents a unique lifeline between the fetus and mother and contains two arteries and one vein wrapped up in Wharton’s jelly with moderate twists. Umbilical coiling abnormalities can result in fetal growth restriction, fetal distress, or intrauterine fetal death. Hypocoiled umbilical cords are associated with intrauterine fetal death (IUFD), fetal growth restriction, fetal distress, low Apgar scores, fetal congenital anomalies, and abnormal insertion of the umbilical cord. Hypercoiled umbilical cords are associated with IUFD, fetal distress, asphyxia, fetal congenital anomalies, and the presence of a single umbilical artery. The aim of this work is to determine if the umbilical Cord coiling index measurement during second trimester ultrasound scan can predict perinatal outcome. Seventy eight healthy uncomplicated pregnant women who regularly attended the antenatal care clinic for antenatal care and to do anomaly ultrasound scan on her baby in 2nd trimester. All participants were informed about the aims and the procedures of the study and signed an informed consent form prior to beginning. Regular antenatal cThe umbilical cord represents a unique lifeline between the fetus andmother and contains two arteries and one vein wrapped up in Wharton’s jelly with moderate twists. Umbilical coiling abnormalities canresult in fetal growth restriction, fetal distress, or intrauterine fetal death. Hypocoiled umbilical cords are associated with intrauterine fetal death (IUFD), fetal growth restriction, fetal distress, low Apgar scores, fetal congenital anomalies, and abnormal insertion of the umbilical cord. Hypercoiled umbilical cords are associated with IUFD, fetal distress, asphyxia, fetal congenital anomalies, and the presence of a single umbilical artery. The aim of this work is to determine if the umbilical Cord coiling index measurement during second trimester ultrasound scan can predict perinatal outcome. Seventy eight healthy uncomplicated pregnant women who regularly attended the antenatal care clinic for antenatal care and to do anomaly ultrasound scan on her baby in 2nd trimester. All participants were informed about the aims and the procedures of the study and signed an informed consent form prior to beginning. Regular antenatal care visit was done every two weeks till delivery with assessment of perinatal outcomes regarding: gestational age at delivery, fetal monitoring by CTG, method of delivery, meconium staining amniotic fluid or not, examination by apgar score at 1stand 5th minute, birth weight, admission to NICU or not and perinatal death. According to umbilical cord index, of total 78 pregnant women who completed the study 62 (79.2%) were having normal UC coiling, 10 of cases (12.8%) were having hypocoiling and 6 (7.7%) were having hypercoiling. Our results showed that hypo- and hyper-coiling were associated with increased incidence of preterm labor (32-36 weeks) “22.2%and 40% respectively” while normo-coiling was associated with lesser incidence “2%”. Both hypocoiling “10%” and hypercoiling “16.7%”groups showed higher incidence of IUGR when compared with the normocoiling group “1.6%”. APGAR score at minute one was significantly lower in the both hypocoiling and hypercoiling groups than the normocoiling group with p- value: 0.005. While at minute five, there was no significant difference between the three groups of the study. Conclusion: The abnormal umbilical coiling index “< 10th percentile or > 90th percentile” is associated with adverse perinatal outcomes. Therefore, early evaluation on Umbilical cord Index in the 2nd trimester can identify fetuses who are at risk and thus help in further management.are visit was done every two weeks till delivery with assessment of perinatal outcomes regarding: gestational age at delivery, fetal monitoring by CTG, method of delivery, meconium staining amniotic fluid or not, examination by apgar score at 1stand 5th minute, birth weight, admission to NICU or not and perinatal death. According to umbilical cord index, of total 78 pregnant women who completed the study 62 (79.2%) were having normal UC coiling, 10 of cases (12.8%) were having hypocoiling and 6 (7.7%) were having hypercoiling. Our results showed that hypo- and hyper-coiling were associated with increased incidence of preterm labor (32-36 weeks) “22.2%and 40% respectively” while normo-coiling was associated with lesser incidence “2%”. Both hypocoiling “10%” and hypercoiling “16.7%”groups showed higher incidence of IUGR when compared with the normocoiling group “1.6%”. APGAR score at minute one was significantly lower in the both hypocoiling and hypercoiling groups than the normocoiling group with p- value: 0.005. While at minute five, there was no significant difference between the three groups of the study. Conclusion: The abnormal umbilical coiling index “< 10th percentile or > 90th percentile” is associated with adverse perinatal outcomes. Therefore, early evaluation on Umbilical cord Index in the 2nd trimester can identify fetuses who are at risk and thus help in further management.

scholarly journals Anemia during Pregnancy: Most Preventable yet most Prevalent

2011 ◽  
Vol 3 (2) ◽  
pp. 75-77 ◽  
Author(s):  
Sulabha Joshi ◽  
Sunita Ghike ◽  
Anuja Bhalerao ◽  
Anjali Kawthalkar
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Antenatal Care ◽  
Perinatal Outcome ◽  
Fetal Death ◽  
Perinatal Death ◽  
Perinatal Outcomes ◽  
Fetal Outcome ◽  
Intrauterine Fetal Death ◽  
Apgar Scores

ABSTRACT Objective To study the relationship between maternal hemoglobin and maternal and perinatal outcomes in a cohort of 1200 women, and to highlight the importance of antenatal care to improve maternal health, maternal and fetal outcome. Method All singleton pregnancies delivering at NKPSIMS, from January 2009 to December 2009 that fulfilled the required criteria were included. Results Out of 1200 women, 787 were anemic (67.2%) < 11 gm of Hb and 413 were nonanemic. Perinatal outcome included preterm delivery, birth weight, intrauterine growth restriction, perinatal death, low Apgar scores and intrauterine fetal death. Risk of preterm and low birth weight among anemic women was 4.2 times and 1.8 times more than nonanemic women. The neonates of anemic women had 1.8 times more risk of low Apgar scores at 1 minute. Among anemic women there was 2.4 times greater risk of intrauterine fetal death than nonanemic women. The women with anemia had 2.5 times higher incidence of PPH than nonanemic women. Puerperal complications were 2.5 times more in anemic women than nonanemic women. Conclusions Regular patient education by imparting proper knowledge regarding iron-rich foods, food fortification, implementation of anemia prophylaxis program from adolescence, regular antenatal care from 1st trimester has a vital role in assessing and managing maternal anemia timely, and it directly affects the perinatal outcome. The patients with anemia have higher risk of having low birth weight, preterm birth and Intrauterine fetal death (Rawalmeds 2007,32:102:101:104).

scholarly journals TWISTING OF THE UMBILICAL CORD CAUSING INTRAUTERINE FETAL DEATH

2012 ◽  
Vol 3 (8) ◽  
Author(s):  
Vidyadhar B Bangal ◽  
Kunaal K Shinde ◽  
Satyajit P Gavhane ◽  
S K Borawake ◽  
Chandaliya R M
Keyword(s):  
Umbilical Cord ◽  
Fetal Death ◽  
Intrauterine Fetal Death

scholarly journals Consensus Definition of Fetal Growth Restriction in Intrauterine Fetal Death: A Delphi Procedure

2020 ◽  
Author(s):  
Irene Maria Beune ◽  
Stefanie Elisabeth Damhuis ◽  
Wessel Ganzevoort ◽  
John Ciaran Hutchinson ◽  
Teck Yee Khong ◽  
...  
Keyword(s):  
Birth Weight ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Fetal Death ◽  
Weight Ratio ◽  
Liver Weight ◽  
Growth Restriction ◽  
Intrauterine Fetal Death ◽  
Consensus Definition ◽  
Definition Of

Context.— Fetal growth restriction is a risk factor for intrauterine fetal death. Currently, definitions of fetal growth restriction in stillborn are heterogeneous. Objectives.— To develop a consensus definition for fetal growth restriction retrospectively diagnosed at fetal autopsy in intrauterine fetal death. Design.— A modified online Delphi survey in an international panel of experts in perinatal pathology, with feedback at group level and exclusion of nonresponders. The survey scoped all possible variables with an open question. Variables suggested by 2 or more experts were scored on a 5-point Likert scale. In subsequent rounds, inclusion of variables and thresholds were determined with a 70% level of agreement. In the final rounds, participants selected the consensus algorithm. Results.— Fifty-two experts participated in the first round; 88% (46 of 52) completed all rounds. The consensus definition included antenatal clinical diagnosis of fetal growth restriction OR a birth weight lower than third percentile OR at least 5 of 10 contributory variables (risk factors in the clinical antenatal history: birth weight lower than 10th percentile, body weight at time of autopsy lower than 10th percentile, brain weight lower than 10th percentile, foot length lower than 10th percentile, liver weight lower than 10th percentile, placental weight lower than 10th percentile, brain weight to liver weight ratio higher than 4, placental weight to birth weight ratio higher than 90th percentile, histologic or gross features of placental insufficiency/malperfusion). There was no consensus on some aspects, including how to correct for interval between fetal death and delivery. Conclusions.— A consensus-based definition of fetal growth restriction in fetal death was determined with utility to improve management and outcomes of subsequent pregnancies.

scholarly journals Maternal and perinatal outcomes of hyperthyroidsm in pregnancy at Dr. Cipto Mangunkusumo Hospital, Jakarta, period of January 2015 - December 2016

2021 ◽  
Vol 29 (1) ◽  
pp. 36
Author(s):  
Fita Maulina ◽  
M Adya F F Dilmy ◽  
Ali Sungkar
Keyword(s):  
Pregnant Women ◽  
Preterm Delivery ◽  
Intrauterine Growth Restriction ◽  
Fetal Death ◽  
Perinatal Outcomes ◽  
Growth Restriction ◽  
Intrauterine Fetal Death ◽  
Adequate Treatment ◽  
Intrauterine Growth ◽  
In Pregnancy

Objectives: To report maternal and perinatal outcomes of hyperthyroidsm in pregnancy.Case Report: There were 3622 cases of delivering pregnant women during the period of the study. From this number, the prevalence of pregnant women with hyperthyroid was 0.2 %. We reported 9 cases of hyperthyroid in pregnancy. The number of pregnancy complication and outcome on pregnant women with hyperthyroidism were preterm labor (44%) and preeclampsia (22%), both were found in group of mother who did taking antihyperthyroid therapy. In those who did not take antihyperthyroid therapy 11% had spontaneous abortion and 11% had preterm delivery. Fetal complications were intrauterine growth restriction (11%) and intrauterine fetal death (23%), both of these complication were on the group who did not take antihyperthyroid. On the contrary, 44% babies were born with normal birthweight in group who took antihyperthyroid.Conclusion: There were differences noted between the group that took adequate treatment and the group that did not take antihyperthyroid. The incidence of intrauterine growth restriction and intrauterine fetal death were high in group that did not took antihyperthyroid therapy but the incidence of preterm delivery as the maternal complication was high in group that did take the antihyperthyroid therapy.  

scholarly journals Comparison between use of combination of mifepristone and misoprostol versus misoprostol alone in the management of intrauterine fetal death

2018 ◽  
Vol 7 (7) ◽  
pp. 2778
Author(s):  
Sreeveena Talasani ◽  
Pran Hitha Venkamolla ◽  
Kalpana Betha
Keyword(s):  
Side Effects ◽  
Fetal Death ◽  
Intrauterine Fetal Death ◽  
P Value ◽  
Ultrasound Scan ◽  
Efficacy And Safety ◽  
Medical Sciences ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Background: Intrauterine fetal death (IUFD) is estimated to occur in 1% of all pregnancies. The advent of prostaglandins has revolutionized the management of IUFD. There are limited studies using a combined regimen of mifepristone and misoprost for induction of labor in IUFD. Hence this study was undertaken to assess the efficacy and safety of combined regimen with misoprostol alone, in the management of IUFD.Methods: This hospital based prospective study included 60 pregnant women with IUFD admitted at Mediciti Institute of Medical Sciences, during the period January 2015 to July 2016. An ultrasound scan was performed to confirm IUFD and localize the placenta. Women were divided alternatively into 2 groups with 30 in each group (group 1- women received 200 mg mifepristone orally followed by misoprostol after 24 hours & in group 2, 100 µg misoprostol  every 6 hourly for a maximum of 4 doses between gestational age  24-26 weeks, 25-50 µg 4 hourly for a maximum of 6 doses beyond 26 weeks).Results: The mean induction to delivery interval was 10 hours in group 1 and 16.3 hours in group 2 (p value 0.007). Mean dose of misoprostol required in group 1 was 1.87 and 2.67 in group 2 (p value 0.008). With respect to side effects, the two groups did not differ significantly.Conclusions: The combined regimen was more effective than misoprostol for the induction of labour in IUFD, in terms of higher rate of successful delivery and shorter induction to delivery interval. 

Intrauterine fetal death caused by large placental chorioangioma and hypercoiled umbilical cord: A case report

Placenta ◽  
2016 ◽  
Vol 46 ◽  
pp. 110
Author(s):  
Genki Sugita ◽  
Masaaki Tanaka ◽  
Takahiro Kanai ◽  
Hiroto Kobayashi ◽  
Yoshiaki Hori ◽  
...  
Keyword(s):  
Case Report ◽  
Umbilical Cord ◽  
Fetal Death ◽  
Intrauterine Fetal Death

scholarly journals Intrauterine Foetal Death: A Hospital Based Study

2022 ◽  
Vol 19 (1) ◽  
pp. 89-91
Author(s):  
Kamar Jahan ◽  
Binod Kumar Mahaseth
Keyword(s):  
Risk Factors ◽  
Antenatal Care ◽  
Fetal Death ◽  
Well Being ◽  
Intrauterine Fetal Death ◽  
Exclusion Criterion ◽  
Foetal Death ◽  
Medical College ◽  
Associated Risk Factors ◽  
Age Range

Introduction: Foetal death at any stage of pregnancy is not just a tragic event but also a more traumatic for the mental well-being of a mother. It is one of the most wrenching events in the field of obstetrics. Aims: The study was done to determine the probable risk factors of intrauterine foetal death and role of antenatal care in its prevention. Methods: The study was conducted  in Obstetrics and Gynecology department at Nepalgunj Medical college from July 2018 to July 2020 .Inclusion criteria were  intrauterine fetal death  of >28 weeks of gestation and baby weighing  1000 grams or more . An exclusion criterion was molar pregnancy. Results: There were 115(3.52%) intrauterine fetal death during the study period, making it 35 per 1000 cases. In 17(14.78%) the cause of intrauterine fetal death was not known. The other common associated risk factors were prematurity in 14(12.17%) and hypertension in 13(11.30%). Similarly anemia and antepartum hemorrhage were seen in 13(11.30%) each. 11(9.56%) patients had oligohydramnios. Mal presentation was found in 8(6.95%) patients while polyhydromnios in 6(5.21%).The commonest age range in whom intrauterine fetal death was seen was 20-30 (73.90%). 28 (24.34%) patients were at preterm pregnancy ranging between 28-30 weeks whereas 17(14.78) intrauterine fetal death occured at  32-34 weeks. 77 foetuses were preterm and their birth weight was between 1 - 1.5 kg  with the mean wt of  1175.73 gms. Conclusion: Intrauterine fetal death is still common inspite of the improving awareness in importance of regular antenatal care. In majority, the cause of intrauterine fetal death is still unknown. However, where the cause was known prematurity was the commonest.

scholarly journals Biomarkers of Inflammation and Redox Imbalance in Umbilical Cord in Pregnancies with and without Preeclampsia and Consequent Perinatal Outcomes

2021 ◽  
Vol 2021 ◽  
pp. 1-17
Author(s):  
Marilene Brandão Tenório Fragoso ◽  
Raphaela Costa Ferreira ◽  
Micaely Cristina dos Santos Tenório ◽  
Fabiana Andréa Moura ◽  
Orlando Roberto Pimentel de Araújo ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Umbilical Cord ◽  
Perinatal Outcomes ◽  
Cross Sectional Study ◽  
Necrosis Factor Alpha ◽  
Cross Sectional ◽  
Redox Imbalance ◽  
Adaptive Mechanisms ◽  
Tnf Α ◽  
Umbilical Cords

Objective. To compare redox imbalance and inflammation biomarkers in umbilical cords from pregnancies with and without preeclampsia (PE) and to analyse their relationships with perinatal outcomes. Methods. A controlled cross-sectional study was conducted in Maceió, Alagoas, Brazil, that involved pregnant women with PE and a group of women without the disease, through the application of a standardized questionnaire. After delivery, umbilical cord samples were collected to measure antioxidant defense, products from oxidative damage, and inflammation biomarkers such as myeloperoxidase (MPO), interleukin- (IL-) 6, IL-8, IL-10, and tumor necrosis factor-alpha (TNF-α). Statistical analyses were performed using Stata version 13.0 software and IBM Statistical Package for the Social Sciences (SPSS) 20.0, adopting a 95% confidence level ( α = 0.05 ), with the chi-square test, the Wilcoxon–Mann–Whitney test, and the multinomial and Poisson regression tests. Results. One hundred PE pregnant women and 50 women without the disease were studied. The umbilical cords from PE pregnancies showed higher levels of reduced glutathione (GSH) ( p ≤ 0.001 ), glutathione peroxidase (GPx) ( p = 0.016 ), and malondialdehyde (MDA) ( p = 0.028 ) and lower levels of IL-6 ( p = 0.030 ) and TNF-α ( p ≤ 0.001 ) than the other group, with some associations among these biomarkers with perinatal outcomes. Conclusion. The higher levels of GSH and GPx, in addition to the lower levels of IL-6 and TNF-α, found in the PE umbilical cord, may result from adaptive mechanisms to maintain the oxidative and inflammatory balance; however, despite these changes, the damage to the cell membranes was not minimized, as the MDA level was higher in women with PE than in women without the disease. This implies that a redox imbalance is present, confirming that other physiological and adaptive mechanisms are being activated to preserve foetal health. Therefore, the present work unveils an important role of the umbilical cord in controlling redox imbalance and inflammation in PE pregnancies. Our results reinforce the necessity for continuous research on GSH as a protective compound for the perinatal outcome, especially in PE women.

scholarly journals Ultrasound Assessment of the Umbilical Cord

2014 ◽  
Vol 8 (4) ◽  
pp. 382-390
Author(s):  
Junichi Hasegawa
Keyword(s):  
Umbilical Cord ◽  
Obstet Gynecol ◽  
Fetal Death ◽  
Current Knowledge ◽  
Ultrasound Diagnosis ◽  
Intrauterine Fetal Death ◽  
Perinatal Morbidity ◽  
Safe Delivery ◽  
Nuchal Cord ◽  
Ultrasound Assessment

ABSTRACT As a nonreassuring fetal status and intrauterine fetal death are often caused by umbilical cord abnormalities, obtaining an ultrasound diagnosis of umbilical cord abnormalities is required for a safe delivery. We believe that the prenatal detection of umbilical cord abnormalities and appropriate management of the delivery improves perinatal morbidity and mortality rates. In the present review, the protocol for ultrasound diagnosis and management of umbilical cord abnormalities, including abnormalities of cord insertion, hypercoiled cord, nuchal cord and fore-lying umbilical cord, is discussed considering current knowledge regarding the physiological and pathological aspects of these umbilical cord abnormalities. How to cite this article Hasegawa J. Ultrasound Assessment of the Umbilical Cord. Donald School J Ultrasound Obstet Gynecol 2014;8(4):382-390.

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