Bilateral Renal Cortical Necrosis in the Newborn

Reisman, Leonard E.; Pathak, Ambadas

doi:10.1001/archpedi.1966.02090080119011

Cited by 35 publications

(9 citation statements)

References 11 publications

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“…Of 22 previously reported pregnancies delivered beyond viability, 11 (50%) were premature [Aberg et al, 1978;Beck et al, 1980;Petres and Redwine, 1981;Redwine and Hays, 1986;Rodeck et al, 1982;Rodeck, 1984;Antsaklis et al, 1984;Kanhai et al, 1986;Dumez and Oury, 1986;Kerenyi and Chitkara, 198 11. There are no known prior reports of successful selective terminations in documented monochorionic pregnancies. These fetuses, which may be discordant for severe anatomical abnormalities, commonly share placental vessels which could lead to the death or possible compromise of the normal fetus after termination of the abnormal fetus [Benirschke, 19611. Much of this concern stems from reports of documented brain damage in the survivor after the spontaneous in utero death of a co-twin [Benirschke, 1961;Reismann and Pothak, 1966;Moore et al, 1969;Koronyi and Kovacs, 1975;Melnick, 19771. It has been proposed that thromboplastin rich blood was transfused from the stillborn fetus to the co-twin via extensive vascular placental anastomoses.…”

Section: Discussionmentioning

confidence: 99%

Selective termination of multiple gestations

et al. 1988

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Twenty-two selective terminations in multiple gestations were performed by a number of different methods. In 17 dichorionic pregnancies there was a successful delivery in surviving singletons or twins. In five monochorionic pregnancies undergoing selective termination there was a successful delivery in only one and a pregnancy loss in the other four. Six of the 18 delivered pregnancies were complicated by premature labor and delivery. Among the several methods used for selective termination, intracardiac potassium chloride injection appears to be the procedure of choice in dichorionic pregnancies.

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Section: Discussionmentioning

confidence: 99%

Selective termination of multiple gestations

et al. 1988

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“…Encephalomalacia was described by patholo gists, in passing, in twins with visceral necro sis or ischemic infarcts [5,17,44,50]. In 1966, Manterola et al [41] described cerebral infarction in a nonmacerated and under weighted stillborn infant whose co-twin sur- vived.…”

Section: Lesions Related To Fetai Conditions Twinningmentioning

confidence: 99%

Fetal Encephalopathies of Circulatory Origin

Larroche¹

1986

Neonatology

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Fetal brain damage may be due to a variety of pathological conditions resulting in circulatory impairments. With generalized ultrasonography of the fetus, the lesions can be detected in utero and subsequent neurological handicaps of the infants will no longer be attributed to difficult labor and birth. The type of the lesions may be anoxic-ischemic and/or hemorrhagic. The morphological appearance depends on the time of occurrence of the insult in utero and on the time elapsed between the insult and the examination of the brain. Although the pathogenesis of the lesions is not fully understood, they may be related either to maternal, fetal, or placental pathological situations. In a last group of cases no causes as yet have been found.

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“…Newborns with bilateral renal cortical necrosis and other findings associated with intravascular coagulation have been described by Moore [61], Reisman [90], and Bernirschke [10] all in association with a dead macerated twin. Bernirschke [10] postulated that fetofetal exchange of thromboplastic material from the dead fetus through vascular shunts in a monochorionic placenta was responsible for this syndrome.…”

Section: Discussionmentioning

confidence: 99%

“…That intravascular coagulation occurs in the neonate has only recently been recognized [47], and the concept that intravascular coagulation may occur in the fetus in utero is relatively new [19,61]. It is significant that a number of newborns with intravascular coagulation recognized within 48 hr of birth and stillborns with the pathological findings of disseminated intravascular coagulation are from pregnancies complicated by sepsis, toxemia with preeclampsia or eclampsia [12,18,38,47], partial or complete abruptio placenta [31,104,105], or retention of a dead macerated twin [10,61,90]. All of these aberrations are known to be associated with intravascular coagulation in the mothers.…”

Section: Introductionmentioning

confidence: 99%

Placental Transfer of Intravascular Coagulation between Mother and Fetus

et al. 1971

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ExtractPregnant sheep of 110-140 days' gestation were used to determine the effect of intravascular coagulation in the mother upon her fetus and the effect of intravascular coagulation in the fetus upon its mother. Because fetal lambs can be delivered and left attached to the mothers via the umbilical cord without placental separation, coagulation studies on a mother and her corresponding fetus could be done simultaneously. When intravascular coagulation was induced in the mothers by administering thromboplastin infusions intravenously, the attached fetal lambs also developed intravascular coagulation with decreased levels in platelets, fibrinogen, and factor V, and prolongation of prothrombin, thrombin, and partial thromboplastin times. When intravascular coagulation was induced in fetal lambs, the dam had a drop in platelet count, a minimal drop in fibrinogen levels, and the appearance of fibrin breakdown products in serum and urine.The factor or factors that crossed the placenta initiating this transfer of coagulation abnormalities are not known. It has been demonstrated that the transfer was not due to fibrin or fibrinogen breakdown products, nor to the infused thromboplastin, and that the trauma of surgery or hypoxia did not contribute to the coagulation abnormalities. The mothers consistently developed fibrin breakdown products in the serum and urine when intravascular coagulation was induced. This was in contrast to the results observed in fetal lambs, which, with one exception, did not show evidence of fibrin breakdown products in serum or urine under identical experimental conditions. These observations suggest the fibrinolytic system of the fetus is inefficient compared with that of the adult; this could be a considerable disadvantage in the presence of intravascular coagulation. SpeculationAs a result of intravascular coagulation in the mother or the fetus a stimulus is produced on the opposite side of the placental barrier resulting in similar changes in the placental partner. This mechanism may be of significance in the etiology of fetal death in eclampsia. Introductionplacentae [4,7,29,33,39,53,69,72,76,82,87,98,111], amniotic fluid embolism [53,68,83,86,88,99, Defects in hemostasis have been described in women 102], retention of a dead fetus [36, 53, 67, 68, 70, 71, with toxemia of pregnancy with preeclampsia or 73, 89, 99, 109, 113], and sepsis [53,68,99]. The eclampsia [28,45,54,68,74,75,94,99], abruptio pathogenesis of coagulation abnormalities has been

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Bilateral Renal Cortical Necrosis in the Newborn

Cited by 35 publications

References 11 publications

Selective termination of multiple gestations

Selective termination of multiple gestations

Fetal Encephalopathies of Circulatory Origin

Placental Transfer of Intravascular Coagulation between Mother and Fetus

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