Umbilical Cord Stricture: A Cause of Recurrent Fetal Death

French, Amy E.; Gregg, Vanessa H.; Newberry, Yvonne; Parsons, Theodore W.

doi:10.1097/01.aog.0000159041.55845.f7

Cited by 27 publications

(27 citation statements)

References 4 publications

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“…Categorization of the cause of the previous stillbirth will allow better estimation of individual recurrence risk of the condition that is associated with stillbirth and help guide management (Tables 5.1 and 5.2). (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29) For example, for women with a previous stillbirth associated with aneuploidy, the recurrence rate of aneuploidy is 1% compared to familial DiGeorge syndrome which has a 50% recurrence risk. These recurrence risks would influence the decision-making process to undergo chorionic villus sampling or amniocentesis.…”

Section: Clinical Factorsmentioning

confidence: 99%

Prediction and prevention of recurrent stillbirth

Reddy¹

2010

Stillbirth

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Stillbirth is one of the most common adverse pregnancy outcomes worldwide with ≥ 3.2 million occurring each year.(1) There are important psychological and emotional issues when dealing with a pregnancy resulting in a stillbirth. Couples experience feelings of anxiety, failure, personal guilt, and apprehension when contemplating pregnancy after having a stillborn infant. Many women do not receive comprehensive counseling regarding the cause of the stillbirth because an incomplete evaluation was performed. Furthermore, in half of the cases the cause remains unknown. It is difficult for clinicians to counsel, evaluate, and manage subsequent pregnancies optimally as very little is known about pregnancy outcome after a stillbirth. RecuRRence Risk of stillbiRthThe overall recurrence risk for stillbirth increased 2-to 10-fold in the next pregnancy. Goldenberg et al.(2) evaluated the association between fetal loss in the second trimester and subsequent adverse birth outcomes. Out of 95 women who had a pregnancy loss at 13-24 weeks in the index pregnancy, 39% had a preterm delivery in their next pregnancy, 5% had a stillbirth, and 6% had a neonatal death. There was almost a sixfold increase in the risk for stillbirth in the subsequent pregnancy for the group of women with a previous 13-to 24-week pregnancy loss compared to the term control group.Samueloff et al.(3) studied the incidence of recurrent stillbirth at an academic center in the United States over a 13-year period. The overall stillbirth rate was 8.3 per 1,000 births. Of the 403 women who had pregnancies subsequent to experiencing a stillbirth, 34 women had a recurrent stillbirth for a rate of 84.3 per 1,000 births. Therefore, the risk was 10-fold higher than that of women who had no previous history of stillbirth.Surkan et al. (4) evaluated the association between previous adverse outcomes of pregnancy and the risk of stillbirth (

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Section: Clinical Factorsmentioning

confidence: 99%

Prediction and prevention of recurrent stillbirth

Reddy¹

2010

Stillbirth

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“…Recurrent IUFD may occur consequentially to repeated thromboembolic events in the umbilicoplacental circulation, in untreated thrombophilias in particular, or antiphospholipid syndrome. Very rarely, recurrent IUFD may be caused by umbilical accidents such as torsion, stricture or knot proper, as in 1 of our cases [19,20] .…”

Section: Discussionmentioning

confidence: 92%

Delivery Course of Macerated Stillborn Fetuses in the Third Trimester

Habek

2008

Fetal Diagn Ther

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Aim: We present and discuss delivery (maternal and fetal) outcome of macerated stillbirths in the third trimester. Material and Methods: In this retrospective observational study, the course of labor was analyzed in 10 stillborn fetuses with a varying grade of maceration during the third trimester. Medical documentation on the course of pregnancy, maternity ward history and histopathology was used to analyze maternal demography data, course of labor, fetal birth weight and birth length, fetal findings (grade of maceration, concomitant finding of cord accidents) and maternal peripartum outcome. Results: Chronic cigarette smoking was recorded in 6, gestational hypertensive disease in 2, intrauterine growth retardation in 2 and abruptio placentae in 3 patients (in 2 of them due to gestational hypertensive disease). Six deliveries were induced by PGE₂ vaginal gel, 2 were stimulated by oxytocin and 1 was initiated spontaneously. One primary cesarean section was performed for evident fetopelvic disproportion. Outlet vacuum extraction for prolonged second labor stage was performed in the macrosomic child in the quadripara and 1 manual assistance according to Bracht was necessary at delivery of a macerated stillborn fetus due to breech presentation. In 1 case of macerated stillborn fetus, head traction resulted in decapitation, therefore extraction with Braun hooks placed into axillary fossae was done to extract the retained macerated fetal body. According to pathoanatomical evaluation, there were 2, 4, 3 and 1 stillbirths with grade 0, I, II and III maceration, respectively. Nuchal cord strangulation and tightened knot were detected in 3 cases each. In 2 cases of abruptio placentae, the parturients developed obstetric shock with uterine atony and disseminated intravascular coagulation. There was no maternal mortality and no fetal malformations in our material. Conclusion: The peripartum course can be considerably compromised due to potential complications induced by autolytic (macerating) lesions and difficult course of labor and maternal outcome.

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“…It is easy to recognize on gross examination 3). It can occur anywhere along the UC length, but it occurs most commonly at the extreme fetal end (1,2,6). It can be independent or associated with other cord anomalies,such as hypocoiling, hypercoiling, torsion, thinning, or excessive length (1,3,6).…”

Section: Discussion:-mentioning

confidence: 99%

“…Umbilical cord stricture (UCS) also named umbilical cord constriction, umbilical cord coarctation, umbilical cord stenosis, refers to an umbilical cord with a strict zone but has still no widely accepted quantitative definition. Even this entity is rare with unknown rate of occurrence (1,2) its link with the intrauterine fetal death IUFD has been established (1,(3)(4)(5). But many others aspects of this condition remain unclear including its etiologies, pathogenesis, the risk of occurrence and the management of subsequent pregnancies (1,3,5).…”

Section: …………………………………………………………………………………………………… Introduction:-mentioning

confidence: 99%