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R Bendon - One of the best experts on this subject based on the ideXlab platform.
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Umbilical Artery occlusion and fetoplacental thromboembolism.
Obstetrics and gynecology, 1995Co-Authors: V Cook, J Weeks, J Brown, R BendonAbstract:To our knowledge, fetoplacental thromboembolism has been described only in autopsy specimens. We report the antepartum diagnosis of an Umbilical Artery occlusion and neonatal diagnosis of an aortic thrombus and placental emboli. A gravida at 31 weeks' gestation was referred for evaluation of decreased fetal movement and an enlarged fetal bladder. A two-vessel Umbilical cord with a collapsed, echogenic third vessel was noted, whereas views of a normal three-vessel cord were available from an examination 5 weeks earlier. A positive oxytocin contraction test prompted delivery. Neonatal color flow Doppler imaging demonstrated an aortic thrombus below the renal arteries and above the bifurcation. Gross and microscopic study of the placenta demonstrated necrosis of the collapsed Umbilical Artery and numerous placental emboli. The aortic thrombus resolved gradually, and the infant went home on the 39th day of life. Umbilical Artery occlusion can be diagnosed ultrasonographically and may be a sign of fetoplacental thromboembolism. Assessment of fetal oxygenation status by biophysical profile or contraction stress test may be helpful in the evaluation of Umbilical Artery occlusion.
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Umbilical Artery occlusion and fetoplacental thromboembolism
Obstetrics & Gynecology, 1995Co-Authors: Vernon D. Cook, J Brown, Jonathan W. Weeks, R BendonAbstract:Background : To our knowledge, fetoplacental thromboembolism has been described only in autopsy specimens. We report the antepartum diagnosis of an Umbilical Artery occlusion and neonatal diagnosis of an aortic thrombus and placental emboli. Case : A gravida at 31 weeks' gestation was referred for evaluation of decreased fetal movement and an enlarged fetal bladder. A two-vessel Umbilical cord with a collapsed, echogenic third vessel was noted, whereas views of a normal three-vessel cord were available from an examination 5 weeks earlier. A positive oxytocin contraction test prompted delivery. Neonatal color flow Doppler imaging demonstrated an aortic thrombus below the renal arteries and above the bifurcation. Gross and microscopic study of the placenta demonstrated necrosis of the collapsed Umbilical Artery and numerous placental emboli. The aortic thrombus resolved gradually, and the infant went home on the 39th day of life. Conclusion : Umbilical Artery occlusion can be diagnosed ultrasonographically and may be a sign of fetoplacental thromboembolism. Assessment of fetal oxygenation status by biophysical profile or contraction stress test may be helpful in the evaluation of Umbilical Artery occlusion.
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Umbilical Artery aneurysm: prenatal diagnosis and management.
Obstetrics & Gynecology, 1992Co-Authors: T A Siddiqi, R Bendon, D M Schultz, M MiodovnikAbstract:Background An Umbilical Artery aneurysm is an extremely rare lesion. The purpose of this report is to describe the prenatal sonographic characteristics of such a lesion and potential obstetric complications. Case A 26-year-old woman, gravida 2, para 1, at 30 weeks' gestation was referred for an ultrasound examination because of "an abnormality of the Umbilical cord." An ellipsoid cystic lesion was noted in a single Umbilical Artery. Doppler and color flow Doppler examinations demonstrated nonpulsatile and turbulent blood flow within the lesion, consistent with a diagnosis of Umbilical Artery aneurysm. The aneurysm increased in size over time with a progressive decrease in amniotic fluid volume. Despite reassuring bi-weekly antenatal testing and planned delivery by 36 weeks' gestation, the fetus died in utero, probably because of acute Umbilical venous compression by the aneurysm. Autopsy confirmed the presence of a large calcified aneurysm of a single Umbilical Artery. Dissection of the aneurysm demonstrated anatomical patency of the entire Artery. The Umbilical vein was histologically normal, as were sections of the Artery. Conclusion Although extremely rare, an Umbilical Artery aneurysm is a potentially lethal anomaly. We recommend delivery as soon as fetal lung maturity is assured when this diagnosis is made prenatally.
M Miodovnik - One of the best experts on this subject based on the ideXlab platform.
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Umbilical Artery aneurysm: prenatal diagnosis and management.
Obstetrics & Gynecology, 1992Co-Authors: T A Siddiqi, R Bendon, D M Schultz, M MiodovnikAbstract:Background An Umbilical Artery aneurysm is an extremely rare lesion. The purpose of this report is to describe the prenatal sonographic characteristics of such a lesion and potential obstetric complications. Case A 26-year-old woman, gravida 2, para 1, at 30 weeks' gestation was referred for an ultrasound examination because of "an abnormality of the Umbilical cord." An ellipsoid cystic lesion was noted in a single Umbilical Artery. Doppler and color flow Doppler examinations demonstrated nonpulsatile and turbulent blood flow within the lesion, consistent with a diagnosis of Umbilical Artery aneurysm. The aneurysm increased in size over time with a progressive decrease in amniotic fluid volume. Despite reassuring bi-weekly antenatal testing and planned delivery by 36 weeks' gestation, the fetus died in utero, probably because of acute Umbilical venous compression by the aneurysm. Autopsy confirmed the presence of a large calcified aneurysm of a single Umbilical Artery. Dissection of the aneurysm demonstrated anatomical patency of the entire Artery. The Umbilical vein was histologically normal, as were sections of the Artery. Conclusion Although extremely rare, an Umbilical Artery aneurysm is a potentially lethal anomaly. We recommend delivery as soon as fetal lung maturity is assured when this diagnosis is made prenatally.
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Umbilical Artery aneurysm: prenatal diagnosis and management.
Obstetrics and gynecology, 1992Co-Authors: T A Siddiqi, R Bendon, D M Schultz, M MiodovnikAbstract:An Umbilical Artery aneurysm is an extremely rare lesion. The purpose of this report is to describe the prenatal sonographic characteristics of such a lesion and potential obstetric complications. A 26-year-old woman, gravida 2, para 1, at 30 weeks' gestation was referred for an ultrasound examination because of "an abnormality of the Umbilical cord." An ellipsoid cystic lesion was noted in a single Umbilical Artery. Doppler and color flow Doppler examinations demonstrated nonpulsatile and turbulent blood flow within the lesion, consistent with a diagnosis of Umbilical Artery aneurysm. The aneurysm increased in size over time with a progressive decrease in amniotic fluid volume. Despite reassuring bi-weekly antenatal testing and planned delivery by 36 weeks' gestation, the fetus died in utero, probably because of acute Umbilical venous compression by the aneurysm. Autopsy confirmed the presence of a large calcified aneurysm of a single Umbilical Artery. Dissection of the aneurysm demonstrated anatomical patency of the entire Artery. The Umbilical vein was histologically normal, as were sections of the Artery. Although extremely rare, an Umbilical Artery aneurysm is a potentially lethal anomaly. We recommend delivery as soon as fetal lung maturity is assured when this diagnosis is made prenatally.
Gerhard Bernaschek - One of the best experts on this subject based on the ideXlab platform.
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Umbilical Artery Doppler velocimetry in fetuses with a single Umbilical Artery.
Obstetrics and gynecology, 1997Co-Authors: Barbara Ulm, M. R. Ulm, Josef Deutinger, Gerhard BernaschekAbstract:Objective: Doppler waveform analysis of the Umbilical Artery is an important tool for the evaluation of high-risk pregnancies. Yet, available data are based on normal values from three-vessel Umbilical cords. Our purpose was to evaluate the value of Umbilical Artery Doppler velocimetry in fetuses with a single Umbilical Artery. Methods: One hundred thirteen consecutive singleton fetuses with a single Umbilical Artery between 16 and 40 weeks' gestational age were studied prospectively at a tertiary referral center for prenatal diagnosis and therapy. Complete follow-up was obtained from 103 cases. Results: The systolic-diastolic ratio in the Umbilical Artery was abnormal in 31 fetuses (30%) and normal in 72 fetuses (70%). Fetuses with abnormal Doppler waveform analysis in the Umbilical Artery were significantly more likely to be growth restricted (55 compared with 15%), to have complex malformations (58 compared with 1%) or an abnormal karyotype (29 compared with 0%), or not to survive the fetal/perinatal period (42 compared with 0%) than those with normal Doppler waveform analysis. Conclusion: Fetuses with a single Umbilical Artery and abnormal Umbilical Doppler velocimetry had a significantly increased risk of adverse fetal and neonatal outcome compared with those with a single Umbilical Artery but normal Doppler studies.
M J Pushchak - One of the best experts on this subject based on the ideXlab platform.
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Umbilical Artery regression: a rare complication of intravascular fetal transfusion.
Obstetrics and gynecology, 1999Co-Authors: J F Smith, K D Warner, M Bergmann, M J PushchakAbstract:Intravascular fetal transfusion is an important therapeutic advance but is associated with several complications. Regression of an Umbilical Artery associated with transfusion is rare. A case of red blood cell alloimmunization managed by serial transfusions was complicated by functional loss of an Umbilical Artery during pregnancy. Refractory fetal bradycardia occurred during the last transfusion procedure, requiring emergency preterm cesarean delivery. Coagulative necrosis, thrombosis, and focal calcification of one Umbilical Artery was confirmed after delivery. Umbilical Artery regression associated with transfusion therapy is rare and may complicate subsequent fetal transfusions.
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Umbilical Artery regression: a rare complication of intravascular fetal transfusion.
Obstetrics & Gynecology, 1999Co-Authors: J F Smith, K D Warner, M Bergmann, M J PushchakAbstract:Abstract Background: Intravascular fetal transfusion is an important therapeutic advance but is associated with several complications. Regression of an Umbilical Artery associated with transfusion is rare. Case: A case of red blood cell alloimmunization managed by serial transfusions was complicated by functional loss of an Umbilical Artery during pregnancy. Refractory fetal bradycardia occurred during the last transfusion procedure, requiring emergency preterm cesarean delivery. Coagulative necrosis, thrombosis, and focal calcification of one Umbilical Artery was confirmed after delivery. Conclusion: Umbilical Artery regression associated with transfusion therapy is rare and may complicate subsequent fetal transfusions.
Jordan H Perlow - One of the best experts on this subject based on the ideXlab platform.
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Umbilical Artery aneurysm a case report literature review and management recommendations
Obstetrical & Gynecological Survey, 2014Co-Authors: Pooja Doehrman, Jordan H Perlow, Brenna J Derksen, William H Clewell, Harris J FinbergAbstract:Background Umbilical Artery aneurysm is a rare and often lethal condition frequently associated with fetal anomalies, fetal demise, and neonatal complications. Case We report a case of Umbilical Artery aneurysm discovered at 21 weeks 2 days of gestation in a fetus of normal karyotype. Maternal hospitalization occurred at 28 weeks for antenatal testing, betamethasone administration, and monitoring for expansion of the aneurysm. Delivery of a live neonate by repeat cesarean delivery was performed at 32 weeks 2 days. Pathology confirmed a 3-vessel cord with an Umbilical Artery aneurysm. Neonatal course was complicated by respiratory distress of the newborn, hyperbilirubinemia, anemia, difficulty feeding, and cardiac defects. The newborn was discharged from the neonatal intensive care unit on day of life 19. Conclusions Umbilical Artery aneurysm is highly associated with fetal complications including trisomy 18, single Umbilical Artery, cardiac anomalies, and intrauterine fetal demise. A normal karyotype, antenatal monitoring, and early delivery have been suggested to impact the likeliness of survival. Antenatal management strategies include consideration of nonstress testing 3 times daily, serial ultrasound assessments, testing to identify intrauterine growth restriction, and delivery by planned cesarean delivery between 32 and 34 weeks. We recommend that patients be counseled on the high risks associated with Umbilical Artery aneurysm and be included in discussions regarding antenatal management and delivery planning.
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Umbilical Artery aneurysm.
Obstetrics and gynecology, 2010Co-Authors: Alexandria J Hill, Thomas H Strong, John P Elliott, Jordan H PerlowAbstract:Umbilical Artery aneurysm is a rare condition associated with increased risk for aneuploidy and fetal demise. We report a case of Umbilical Artery aneurysm discovered at 27 weeks of gestation in one fetus of a dichorionic, diamniotic twin pregnancy. The patient was hospitalized to monitor for expansion of the aneurysm. Corticosteroids were administered, and, after genetic amniocentesis revealed a normal karyotype, cesarean delivery was performed at 28 2/7 weeks of gestation. Pathologic examination confirmed an Umbilical Artery aneurysm in the cord of the affected fetus. Given the high incidence of aneuploidy associated with Umbilical Artery aneurysm, it is important to consider karyotype analysis of the affected fetus. If a normal karyotype is identified, early delivery may be warranted to decrease the risk of fetal demise.
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Umbilical Artery aneurysm
Obstetrics & Gynecology, 2010Co-Authors: Alexandria J Hill, Thomas H Strong, John P Elliott, Jordan H PerlowAbstract:Background Umbilical Artery aneurysm is a rare condition associated with increased risk for aneuploidy and fetal demise. Case We report a case of Umbilical Artery aneurysm discovered at 27 weeks of gestation in one fetus of a dichorionic, diamniotic twin pregnancy. The patient was hospitalized to monitor for expansion of the aneurysm. Corticosteroids were administered, and, after genetic amniocentesis revealed a normal karyotype, cesarean delivery was performed at 28 2/7 weeks of gestation. Pathologic examination confirmed an Umbilical Artery aneurysm in the cord of the affected fetus. Conclusion Given the high incidence of aneuploidy associated with Umbilical Artery aneurysm, it is important to consider karyotype analysis of the affected fetus. If a normal karyotype is identified, early delivery may be warranted to decrease the risk of fetal demise.
