No abstract

Anencephaly is a severe neural tube defect (NTD) caused by failure of closure in the cranial neuropore during fourth week of pregnancy. As a result, major portion of the brain, skull and scalp is absent. Anencephaly may be associated with rachischisis, where defective neural tube closure is extensive and spinal cord is exposed. Overall incidence of anencephaly is one in every 1000 births. It can be easily diagnosed by ultrasonography. Anencephaly newborns are not viable nor treatable and classified as lethal NTDs. Nutritional and environmental factors play a role in production of NTDs. Here we report and discuss a rare case of anencephalic fetus with craniospinal rachischisis of 25 weeks of gestation and their embryological origin.

Objective: To evaluate the histomorphometry of umbilical cord (UC) in intrauterine growth restricted (IUGR) newborns compared to appropriate for gestational age (AGA) newborns, and secondly to assess its impact on the intrapartum and perinatal outcome. Materials and Methods: A prospective observational study was conducted at Obstetrics and Gynecology unit of KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi. Study involved total 130 UCs of AGA and IUGR newborns. Tissues were fixed in formalin and paraffin embedded sections were examined. For each UC; UC cross sectional area (CSA), UC diameter and UC circumference parameters were measured under microscope with the help of digital image analyzer. Perinatal outcome like gestational age (GA) at delivery, birth weight, mode of delivery, sex of newborn, neonatal outcome and intrapartum complications were recorded. Independent t test was used to compare means and chi-square test for categorical variables. Results: UC of IUGR newborns had significantly reduced UC area, diameter and circumference as compared to AGA newborns. IUGR newborns were associated with significant difference in GA at delivery, birth weight, neonatal intensive care unit admissions (NICU) and fetal distress. No significant difference was found in mode of delivery, sex of newborn and meconium stained liquor among AGA and IUGR groups. Conclusion: Assessment of CSAs of UC and its components can be used as early screening tool for fetal growth and it may provide useful information about pregnancy at risk and help in averting poor perinatal outcome.

Background: Umbilical vessels are an extension of the fetal cardiovascular system, which are essential parts of fetal circulation and fetal wellbeing. Umbilical vessels are altered in maternal and fetal conditions, so they can be used to predict adverse pregnancy outcomes. Prenatal sonographic studies have developed nomograms of umbilical vessels in normal pregnancies and established their relationship with fetal biometry. However, there is a scarcity of such studies in the postnatal period. Aim and objective: The aim and objective is to develop postdelivery histomorphometrical reference values for area and diameter of umbilical vessels across the available gestational age (GA) spectrum in low-risk pregnancies and secondly to examine the nature of its association with neonatal anthropometry. Materials and methods:A cross-sectional study was carried out on 164 low-risk pregnant women between GA of 32 and 42 weeks. Umbilical cord (UC) samples were procured soon after delivery. Formalin-fixed paraffin-embedded tissue blocks were processed, stained, and histomorphometric measurements of umbilical vessels were carried out by Olympus microscope. Neonatal anthropometry was noted. The mean and percentile were calculated for each GA. Pearson's Correlation was used to assess the relationship between umbilical vessels parameters with neonatal anthropometry. Results: Reference values and percentiles of diameter and area of umbilical vessels for each GA were calculated. Cross-sectional area and diameter of umbilical vein (UV) attained peak at 34 weeks of GA whereas both umbilical arteries (UAs) reached the peak at 36 weeks of GA and stabilized thereafter. A statistically significant positive correlation was observed between all umbilical vessels parameters with all neonatal anthropometric measurements (p <0.001). The regression equation for the prediction of newborn birth weight (y) according to the area (A) of umbilical vessels is 1.750 + 0.343(UA2A) + 0.248(UVA). It shows that the area of UA2 and UV are good predictors of newborn birth weight. Conclusion:The study provides reference values of umbilical vessels area and diameter of post-delivery from 32 to 42 weeks of gestation in low-risk pregnancies. These reference values of umbilical vessels provide baseline values for pathological and perinatal studies in the future. The study showed a positive relationship between umbilical vessels measurements and neonatal anthropometry. These results may be useful during perinatal pathological examination of UC and can be used as a predictor for neonatal complications.