Personalized Medicine in a Patient With the Antenatal Diagnosis of an Umbilical Cord Knot and a Previous Adverse Outcome for This Reason

2014 ◽  
Vol 33 (4) ◽  
pp. 735-736 ◽  
Author(s):  
Rachael L. Polis ◽  
Joaquin Santolaya-Forgas ◽  
Corey Tong ◽  
Gail Onieal ◽  
Joseph C. Canterino ◽  
...  
Keyword(s):  
Personalized Medicine ◽  
Umbilical Cord ◽  
Antenatal Diagnosis ◽  
Adverse Outcome

scholarly journals Antenatal Diagnosis of Short Umbilical Cord Syndrome

2001 ◽  
Vol 17 (5) ◽  
pp. 253-257
Author(s):  
Carol C. Mitchell ◽  
John Yeast ◽  
J. R. Dobson
Keyword(s):  
Umbilical Cord ◽  
Antenatal Diagnosis

scholarly journals Intraplacental Leiomyoma in a Case of Second-Trimester Intrauterine Fetal Demise

2020 ◽  
Vol 13 ◽  
pp. 2632010X2092832
Author(s):  
Selene C Koo ◽  
Fang Bu
Keyword(s):  
Smooth Muscle ◽  
Umbilical Cord ◽  
Incidental Findings ◽  
Adverse Outcome ◽  
Implantation Site ◽  
Rare Tumor ◽  
Second Trimester ◽  
Histological Findings ◽  
Fetal Demise ◽  
Intrauterine Fetal Demise

Intraplacental leiomyomas are extremely rare and are generally incidental findings in term placentas. We present the first reported case of a placental leiomyoma associated with preterm intrauterine fetal demise, with histological findings providing the cause of adverse outcome. This was an intrauterine fetal demise detected at 26 weeks gestation with a placental finding of a 2.8-cm leiomyoma. Histological findings in the placenta and fetus were consistent with intrauterine fetal demise of weeks. The umbilical cord was markedly hypercoiled, with 6 twists per 10 cm. Features of maternal vascular malperfusion were evident in the placenta, including villous hypermaturity, an infarct adjacent to the leiomyoma, and retention of smooth muscle in spiral arterioles within the decidua overlying the leiomyoma. Implantation-site trophoblasts invaded into the leiomyoma and the overlying decidua. We hypothesize that incorporation of the leiomyoma into the placenta contributed to fetal demise due to disordered placental implantation, implying that these tumors may not be as benign and incidental as previously described. The finding of implantation-site changes in the leiomyoma may also suggest a potential cause for this rare tumor.

scholarly journals A decade of toxicological trends: what the papers say

2020 ◽  
Vol 9 (5) ◽  
pp. 676-682
Author(s):  
Phumzile Sikakana ◽  
Ruth A Roberts
Keyword(s):  
Personalized Medicine ◽  
Adverse Outcome ◽  
Rank Order ◽  
Human Microbiome ◽  
Drug Efficacy ◽  
Scientific Culture ◽  
New Concepts ◽  
Microphysiological Systems ◽  
New Ideas ◽  
Adverse Outcome Pathways

Abstract Here we look at popular trends and concepts in toxicology over the decade 2009–2019. The top 10 concepts included methodological approaches such as zebrafish and genomics as well as broader concepts such as personalized medicine and adverse outcome pathways. The total number and rank order for each of the top 10 were tracked year by year via PubMed with >9500 papers contributing to the analysis. The data revealed a slow upward trend in the number of papers across all the concepts from 260 in 2009 to >1700 in 2019. Zebrafish, genomics and personalized medicine remained in the top four slots since 2009 with zebrafish dominating the rankings over the entire decade. Genomics was a strong second until 2013 when it was displaced first by the microbiome in 2014 and secondly by personalized medicine in 2015. Other notable trends were the ascendancy of the microbiome and adverse outcome pathways and the descendancy of hormesis and the 3Rs (replacement, reduction and refinement of animals in testing). The observation that the top four slots have been static over the past 4 years suggests that new ideas are introduced and increase in popularity until they find their place in scientific culture. This may suggest that relatively new concepts such as artificial intelligence and microphysiological systems have yet to find their steady state in the rankings. Similarly, as a relatively new player in toxicology, the full impact of the human microbiome on drug efficacy and safety remains to be seen.

Adverse outcome of congenital diaphragmatic hernia is determined by diaphragmatic agenesis, not by antenatal diagnosis

1999 ◽  
Vol 34 (11) ◽  
pp. 1740-1742 ◽  
Author(s):  
S.J Singh ◽  
G.E Cummins ◽  
R.C Cohen ◽  
D Cass ◽  
J.G Harvey ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Antenatal Diagnosis ◽  
Adverse Outcome

scholarly journals HDliveFlow with HDlive Silhouette Mode in Antenatal Diagnosis of Bilobed Placenta

2016 ◽  
Vol 10 (4) ◽  
pp. 415-417 ◽  
Author(s):  
Megumi Ishibashi ◽  
Pei-Yin Yang
Keyword(s):  
Pregnant Woman ◽  
Umbilical Cord ◽  
Gestational Age ◽  
Obstet Gynecol ◽  
Antenatal Diagnosis ◽  
Anterior Part ◽  
In Utero ◽  
Two Dimensional ◽  
Old Japanese ◽  
Live Fetus

ABSTRACT We present a case of bilobed placenta diagnosed by HDliveFlow with the HDlive silhouette mode early in the 2nd trimester of pregnancy. A 29-year-old Japanese pregnant woman, gravida 4, para 1, was referred to our hospital based on the patient's wish at 23 weeks and 3 days of gestation. Two-dimensional (2D) sonography showed a single live fetus with biometry consistent with the gestational age. Moreover, two separated parts of the placenta were noted at the anterior and posterior uterine walls. HDliveFlow with the HDlive silhouette mode clearly depicted two lobes of the placenta (near equal size), and the main umbilical cord attached to the periphery of the anterior part of the placenta. One large connecting vessel between these two placental parts was also clearly identified. Bilobed placenta was strongly suggested. After birth, the gross specimen of the placenta confirmed the diagnosis. HDliveFlow with the HDlive silhouette mode may be an adjunctive tool to 2D sonography to diagnose abnormalities of the placenta in utero. How to cite this article Yang P-Y, Kanenishi K, Ishibashi M, Mori N, Hata T. HDliveFlow with HDlive Silhouette Mode in Antenatal Diagnosis of Bilobed Placenta. Donald School J Ultrasound Obstet Gynecol 2016;10(4):415-417.

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.

Prenatal diagnosis of fetal umbilical cord teratoma

2014 ◽  
Vol 3 (2) ◽  
Author(s):  
Bilge Cetinkaya Demir ◽  
Naile Bolca Topal ◽  
Esra Şahin Güneş ◽  
Zeynep Yazıcı ◽  
Ulviye Yalçınkaya
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prenatal Diagnosis ◽  
Magnetic Resonance ◽  
Umbilical Cord ◽  
Antenatal Diagnosis ◽  
Correct Diagnosis ◽  
Resonance Imaging ◽  
Germ Layers ◽  
Ultrasonographic Appearance

AbstractUmbilical cord teratomas are rare tumoral lesions of umbilical cord which have challenging antenatal diagnosis. The cord teratomas contain tissue from all three germ layers and have both cystic and solid components. This ultrasonographic appearance may help the clinician to clarify the correct diagnosis. We report a case of cord teratoma diagnosed prenatally by ultrasonography and magnetic resonance imaging. Since cord teratomas may lead to adverse fetal outcomes, close follow-up of the fetus is recommended.

Neonatal Outcomes Associated with Umbilical Cord Milking in Preterm Multiple Gestations

2019 ◽  
Vol 36 (10) ◽  
pp. 990-996 ◽  
Author(s):  
Christina E. Rodriguez ◽  
Torri D. Metz ◽  
Shrena Patel ◽  
Minda Abbaszadeh ◽  
Bradley A. Yoder ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Umbilical Cord ◽  
Regression Models ◽  
Adverse Outcome ◽  
Univariable Analysis ◽  
Historical Cohort ◽  
Logistic Regression Models ◽  
Multiple Gestations ◽  
Historical Controls ◽  
Umbilical Cord Milking

Objective Our aim was to evaluate the effect of umbilical cord milking on outcomes for preterm multiples. Study Design We implemented a policy of cord milking in neonates born at less than 30 weeks' gestation in September 2011. We compared cord milking in multiples with a historical cohort. Multivariable logistic regression models estimated the effect of cord milking on a composite neonatal adverse outcome. Secondary outcomes were hematocrit at birth, need for blood transfusion, and inotrope use. Results We identified 149 neonates (120 twins, 29 triplets), 51 historical controls, and 98 neonates with cord milking. Cord milking was associated with a lower rate of adverse composite neonatal outcome in univariable analysis (odds ratio [OR]: 0.36; 95% confidence interval [CI]: 0.15–0.84). However, in multivariable modeling, the effect was not significant (adjusted OR [aOR]: 0.54, 95% CI: 0.23–1.28). Hematocrit was 4.6 unit % (95% CI: 2–7.3) higher in the cord milking group, and cord milking was associated with a lower rate of blood transfusion (aOR: 0.28; 95% CI: 0.1–0.74; p = 0.01). There was no difference in inotrope administration. Conclusion Umbilical cord milking was not associated with a decrease in composite neonatal adverse outcome. However, we observed an increase in hematocrit and decreased need for blood transfusion in neonates with cord milking.

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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