Thrombosis of the umbilical vessels revisited. An observational study of 317 consecutive autopsies at a single institution

Avagliano, Laura; Marconi, Anna Maria; Candiani, Massimo; Barbera, Antonio; Bulfamante, Gaetano

doi:10.1016/j.humpath.2009.07.026

Cited by 47 publications

(46 citation statements)

References 32 publications

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“…Placental macroscopic inspection of the maternal and fetal plates, umbilical cord and membranes was carried out as previously reported [19]. Placental sampling was conducted according to international criteria [20].…”

Section: Methodsmentioning

confidence: 99%

Stillbirths at Term: Case Control Study of Risk Factors, Growth Status and Placental Histology

et al. 2016

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ObjectiveTo investigate the proportion of stillbirths at term associated with abnormal growth using customized birth weight percentiles and to compare histological placental findings both in underweight stillborn fetuses and in live births.MethodsA retrospective case-control study of 150 singleton term stillbirths. The livebirth control groups included 586 cases of low-risk pregnancies and 153 late fetal growth restriction fetuses. Stillbirths and livebirths from low-risk pregnancies were classified using customized standards for fetal weight at birth, as adequate for gestational age (AGA; 10-90th percentile), small (SGA; <10th percentile) or large for gestational age (LGA; >90th percentile). Placental characteristics in stillbirth were compared with those from livebirths using four categories: inflammation, disruptive, obstructive and adaptive lesions.ResultsThere was a higher rate of SGA (26% vs 6%, p<0.001) and LGA fetuses (10.6% vs 5.6%, p<0.05) in the stillbirth group. Among stillbirth fetuses, almost half of the SGA were very low birthweight (≤3°percentile) (12% vs 0.3%, p<0.001). The disruptive (7.3% vs 0.17%;p<0.001), obstructive (54.6% vs 7.5%;p<0.001) and adaptive (46.6% vs 35.8%;p<0.001) findings were significantly more common in than in livebirth-low risk. Placental characteristics of AGA and SGA stillbirth were compared with those of AGA and FGR livebirth. In stillbirths-SGA we found a higher number of disruptive (12.8% vs 0%; p<0.001), obstructive (58.9% vs 23.5%;p<0.001) and adaptive lesions (56.4% vs 49%; p 0.47) than in livebirth-FGR.ConclusionThe assessment of fetal weight with customized curves can identify fetuses which have not reached their genetically determined growth potential and are therefore at risk for adverse outcomes. Placental evaluation in stillbirths can reveal chronic histological signs that might be useful to clinical assessment, especially in underweight fetuses.

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Section: Methodsmentioning

confidence: 99%

Stillbirths at Term: Case Control Study of Risk Factors, Growth Status and Placental Histology

et al. 2016

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“…Placental macroscopic inspection of the maternal and fetal plates, umbilical cord and membranes was carried out as previously reported [10] and placental sampling was conducted according to international criteria [11]. Briefly, at least one free membrane roll, one section of the umbilical cord and three conventional full-thickness sections of grossly unremarkable placental parenchyma were sampled for histological examination.…”

Section: Placental Examinationmentioning

confidence: 99%

Placental histology in clinically unexpected severe fetal acidemia at term

Avagliano

Locatelli

Danti

et al. 2015

Early Human Development

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“…The literature search yielded 172 articles, 27 of which met the inclusion criteria for neonatal spontaneous arterial embolism [1][2][3][4][5][6]9,11,12,18,20,25,[27][28][29]31,[34][35][36][37][38][39][40][41][42][43][44] (Fig. 1).…”

Section: Introductionmentioning

confidence: 99%

Spontaneous neonatal arterial thromboembolism

Rashish

Paes²,

Nagel³

et al. 2013

Blood Coagulation &Amp; Fibrinolysis

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Neonatal spontaneous arterial thromboembolism is a rare phenomenon with a high risk of morbidity and mortality. Currently, there is little information regarding common risk factors, diagnostic strategies, therapeutic interventions, and outcomes of this condition. The objective was to nucleate the best evidence regarding the disorder in order to facilitate early detection and treatment recommendations and document adverse outcomes. Web of Science, PubMed, Medline, CINAHL, Cochrane Databases, DARE, and OVID databases were searched using the following keywords: 'arterial' AND 'thrombus' OR 'thrombosis' OR 'thromboembolism' OR 'embolism' AND 'spontaneous' AND 'at birth' OR 'newborn' OR 'neonatal' OR 'fetal' AND 'umbilical cord' OR 'umbilical wall necrosis' AND 'coagulation abnormality' OR 'placenta bits' OR 'ischemic limbs'. The search yielded 172 articles, all of which were case series or single case descriptions. Twenty-seven met inclusion criteria, with a total of 53 newborns and 30 newborn pathology reports. Ultrasound was the preferred method of diagnosis and thromboembolic locations varied with the most common site being umbilical, resulting in embolism and vascular compromise. Treatment interventions and drug dosages were not standardized and ranged from use of anticoagulants to surgery and hyperbaric oxygen. The reported mortality rate was 32.8%. Recurring etiological features facilitated identification of possible sequences of events contributing to the disorder. The literature lacks empirical evidence to affirm causes and predisposing risk factors for timely diagnosis and effective treatment of spontaneous neonatal arterial thromboembolism. Further research is needed to clearly establish the causes and the efficacy of specific treatment options.

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Thrombosis of the umbilical vessels revisited. An observational study of 317 consecutive autopsies at a single institution

Cited by 47 publications

References 32 publications

Stillbirths at Term: Case Control Study of Risk Factors, Growth Status and Placental Histology

Stillbirths at Term: Case Control Study of Risk Factors, Growth Status and Placental Histology

Placental histology in clinically unexpected severe fetal acidemia at term

Spontaneous neonatal arterial thromboembolism

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