Cord

The human placenta plays a pivotal role in development and growth of the fetus. Disorder of this multifunctional organ is central to various fetal disorders. Doppler sonography and MRI provide excellent diagnostic evaluation of the placental morphology and umbilical cord. Decades of experience in obstetric imaging have highlighted the need of careful prenatal assessment of placenta. However, in most of the routine obstetric scans, the evaluation and reporting of the placental examination is limited to the location and grade of the placenta. The purpose of this article is to review the existing literature and facilitate step-by-step evaluation of the placenta and umbilical cord by the radiologists.

Introduction: Neonatal death due to infections is still a great concern worldwide. Umbilical cord related infections play significant role in the neonatal mortality specially in very low birth weight infants, mother chorioamnionitis and premature rupture of membranes. It is associated with umbilical colonization, delayed separation and poor hygiene. In the current study, effect of topical breast milk usage with dry cord care on separation time, complications and colonization were compared. Methods This is a randomized clinical-trial on 150 very low birth weight neonates in 2016-18. Patients' were divided in two groups; Group-M (N = 73) (3–4 drops of maternal breast milk were dropped on the umbilical cord stump within eight hours of birth and went on every eight hours until 48-hours after cord separation) and Group-D (N = 77) (the umbilical cord was drought gradually in open air). Umbilical cord culturing was performed from cord stump within 2–4 hours after delivery, three days a...

Background: To compare the cord blood lipid profile of 100 newborn babies born to hypertensive (Group A) and normotensive mothers (Group B).Methods: Total 100 newborns were taken, 50 born to hypertensive mothers and 50 to normotensive mothers. 5ml umbilical venous blood was collected, after clamping the cord, from placental side of the cord and sent to laboratory for centrifugation. Serum was analysed for lipid profile by spectrophotometry by siemens dimensional Rxl- Total Cholesterol, Triglycerides, High density lipoprotein and Low density lipoprotein and Very low density lipoprotein. Comparison of the cord blood lipid levels in both the groups was done.Results: Cord blood lipid profile was deranged in newborns of hypertensive mothers with Cord TC, TG and LDL being statistically significantly higher than the mean reference value and 95th centile. Cord blood of term newborns of hypertensive mothers had Cord TC TG and LDL being statistically higher whereas only Cord TC being statisti...

Background. There are increasing reports of term live abdominal pregnancies even though the diagnosis of abdominal pregnancy is made preoperatively only in 45% of cases which partly explains the high maternal and perinatal morbidity and mortality associated with abdominal pregnancy. Case Report. We report a rare case of misdiagnosed term abdominal pregnancy complicated by fetal demise due to cord round neck in a 29-year-old G3P2002 at 39-week and 1-day gestation. She noticed reduced fetal movements for which upon examination fetal death was diagnosed. Cervical ripening was started which eventually failed, and surgery was indicated. Findings were an abdominal pregnancy with a third-degree macerated fetus with cord round neck. She was discharged on day 8 postoperation to continue follow-up as an outpatient with regular βHCG and ultrasound checks. Conclusion. This case illustrates the need to effectively confirm an intrauterine location of a pregnancy even in a case of fetal demise and...

INTRODUCTION :- The well being of the fetus and hence the baby is influenced by a number of factors among which the length and diameter of umbilical cord is one important aspect. Studies have found association between gestational hypertension and the structure of umbilical cord. The objective of this study was to determine the effects of gestational hypertension on the length and diameter of umbilical cord.  MATERIAL AND METHODS :- A total of 70 umbilical cords with placenta were collected in Nobel Medical College and Teaching Hospital for comparison of umbilical cords length and diameter between normotensives and patients with gestational hypertension. Data were statistically analyzed.  RESULTS :- The difference in umbilical cords' diameter was statistically significant between normotensives and patients with gestational hypertension whereas the length of the umbilical cord had no statistically significant difference.  CONCLUSION :- We concluded that gestational hypertension af...

It has been shown that animal spinal cord compression (using methods such as clips, balloons, spinal cord strapping, or calibrated forceps) mimics the persistent spinal canal occlusion that is common in human spinal cord injury (SCI). These methods can be used to investigate the effects of compression or to know the optimal timing of decompression (as duration of compression can affect the outcome of pathology) in acute SCI. Compression models involve prolonged cord compression and are distinct from contusion models, which apply only transient force to inflict an acute injury to the spinal cord. While the use of forceps to compress the spinal cord is a common choice due to it being inexpensive, it has not been critically assessed against the other methods to determine whether it is the best method to use. To date, there is no available review specifically focused on the current compression methods of inducing SCI in rats; thus, we performed a systematic and comprehensive publication...

Background Pregnancy immunization is recommended to protect babies against pertussis, which has a high mortality and morbidity during infancy, but whooping cough vaccine is not given to pregnant women in Turkey. In this study, pertussis antibodies in maternal and cord blood were investigated. Methods The study group was one hundred and fifty-four mothers who gave birth at Hacettepe University Hospitals in Ankara, from July to October 2020. The information of the mothers was collected by questionnaire and sera were taken. In this descriptive epidemiological study, anti-PT and anti-FHA were investigated with ELISA (EUROIMMUN B. Pertussis toxin (PT) IgG, Filamentous Hemagglutinin (FHA) IgG) method in maternal and cord-paired sera, the limit value was accepted as 10 IU/ml. Anti-ACT was investigated in the sera of 79 mothers who were anti-PT or anti-FHA positive by Immunblot (EUROIMMUN Adenylate Cyclase Toxin (ACT) IgG) method. Correlation analysis of continuous numerical variables was p...

Leiomyosarcoma of the larynx is an extremely rare malignancy. Until now, only 35 cases have been reported, and only 19 were reported in English. We present 2 new cases observed in the last 3 years at our department. Correct histologic diagnosis can only be made on immunohistochemical and electron microscopic grounds. A 65-year-old man previously treated for a premalignant vocal cord lesion and a 31-year-old woman who previously underwent operation on a benign vocal cord lesion are presented. Only surgical treatment (total laryngectomy and endolaryngeal laser resection) was performed. Thirty-six and 22 months after the initial surgical intervention, both patients are alive and well, with no evidence of local recurrence or distant metastasis.

Patients presenting with a monosymptomatic episode of neurologic dysfunction (MEND) have a high probability of developing multiple sclerosis (MS). Our study was designed to determine whether magnetization transfer (MT) histogram analysis could predict the development of MS for a cohort of patients presenting with a MEND. Eleven patients with a MEND and 21 age-matched control volunteers underwent MR imaging. Six patients underwent serial MR examinations. MT ratio histogram peak height (MTRHPH) and the location of the MT ratio histogram peak (LOC MTRHP) were determined for patients and control volunteers. T2 lesion volume was also calculated. Patients were clinically followed up for 587 +/- 308 days to determine or rule out the development of MS. Three patients went on to develop MS. There was no statistically significant difference in the MTRHPH (P = .65) and the LOC MTRHP (P = .71) between patients and control volunteers. For those patients who underwent multiple examinations, no st...

Background: The umbilical cord is the life line of fetus and its vital blood vessels are the most vulnerable part of the fetal anatomy. Objectives: The objective of the current study was to recognize the insertion site and to study the histological appearance of the cord at different gestational periods. Results: The study revealed that eccentric site of location was 64.99% the central insertion 28.33% and marginal insertion 6.66%. Conclusion: Microscopic study of umbilical artery revealed that the measurements of thickness of muscular layer (tunica media) was increased from 0.6µm at the third month of gestation to 9.2µm at ninth month (at delivery) which may explain the increase in strength and elasticity of the cord against torsion and compression as the fetus became near the term.     

PurposeRespiration affects the bulk magnetic susceptibility, causing frequency shifts as shown in the brain at 7T. Due to the close proximity of the spine to the lungs, this effect is expected to be even larger in the spinal cord, resulting in detrimental B0 offset. The goal of this study was to quantify the effect of respiration on B0 variation in the spinal cord.MethodsSeven healthy subjects were scanned at 3T. Field maps were acquired during inspired and expired conditions. Frequency shift was quantified in the brain, brainstem, and cervico‐thoracic spinal cord. A skewed Gaussian function with linear term was fitted to the frequency shift as a function of z‐location along the spine.ResultsLarge frequency shifts were measured along the cord, with a maximum of 74 Hz at C7 (P < 0.05), corresponding to 0.58 ppm. The proposed model was adequately fitted to the respiratory‐induced frequency‐shifts (adjusted R2 = 0.9954). The morphology of subjects (weight and height) seemed to have ...

Background: Keeping the umbilical cord intact the first minutes after delivery is beneficial for both term and preterm infants. However, this may be challenging in caesarean sections (CS) due to lack of mobile resuscitation equipment, maintenance of sterility or concern for excessive maternal blood loss. The objective of this study was to develop and pilot-test extra-uterine placental transfusion and intact-cord stabilisation of infants in CS. Methods: The intervention development process (phase 1) covered: A) placenta delivery without cord clamping, B) intact-cord stabilisation of the infant and C) physiology-based cord clamping. Different scenarios were tested through in-situ simulation and adjusted through multiple feedback rounds. The involved staff were trained prior to pilot-testing (phase 2). Women having a CS in regional anaesthesia, expecting a term or near-term singleton infant were included in the pilot-study after written consent. Primary outcome was the proportion of su...

Angioleiomyomas, as the name suggests, are tumors arising from smooth muscle of vascular tissue. We report a case of angioleiomyoma arising from the right vocal cord in a 45-year-old male with a history of squamous cell carcinoma (SCC) of the oral cavity who had restricted mouth opening owing to previous surgery and adjuvant radiation therapy because of which accessing the vocal cord tumour was difficult by conventional laryngoscopy. Initial bronchoscopy guided excision of the tumour was done. After a month, an emergency tracheostomy had to be performed as he presented with stridor due to recurrence of tumour. Laryngofissure was performed and tumour was excised. The patient is on regular follow up with no recurrence of tumour. We present in this case report, the clinical presentation, diagnosis, management options, pathological features and outcomes of this rare entity known as laryngeal angioleiomyoma. 

Background:  Assessment of vocal cord mobility using Macintosh laryngoscope is frequently performed after extubation following thyroid surgery to rule out laryngeal nerve palsy. This study compared patient comfort and assessment accuracy of post‐operative vocal fold mobility with Macintosh laryngoscope and fibreoptic endoscope.Methods:  One hundred four physically fit patients undergoing thyroid surgery were included for the study. Tele‐laryngoscopy was done to rule out pre‐existing vocal cord palsy. Direct laryngoscopy (DL) was performed to each patient after extubation, followed by nasal fibreoptic endoscopy (NFE) to assess the vocal cord mobility. Tele‐laryngoscopic assessment was repeated after 1 week to compare the DL and NFE findings. Patient reactivity score (PRS) and haemodynamic parameters were recorded with each technique.Results:  Macintosh laryngoscope could pick up 4 (50% sensitivity and 88% specificity) and fibreoptic endoscope 7 (87.9% sensitivity and 98.9% specificit...

Maintaining iron homeostasis is of great importance to the growing fetus and neonates. There is no consensus as to whether the neonates iron status is determined by fetal demands or by maternal iron status. There is no conclusive data confirming the likelihood of neonates born to anemic mothers suffering from compromised iron status. Therefore the aim of our study was to evaluate the relationship of iron indices between maternal and cord blood collected from mother and infant pairs and explore the association of maternal anemia on the iron status indicators of the cord blood. This prospective study included 60 mother and newborn pairs. The study population was subdivided as anemic and non-anemic groups based on hemoglobin (Hb) levels. The maternal venous blood samples were collected 1.5 h ± 20 min before the delivery. 5 ml of cord blood was collected soon after child birth. Samples were analyzed for hemoglobin (Hb), serum ferritin and iron. Significantly lower values of Hb, Ferritin...

We aimed to investigate the correlation between total deceleration area (TDA), neonatal birthweight and neonatal acidemia in vacuum extractions (VEs). This is a retrospective study in a tertiary hospital, including VE performed due to non-reassuring fetal heart rate (NRFHR). Electronic fetal monitoring during the 120 min preceding delivery was interpreted by two obstetricians who were blinded to neonatal outcomes. TDA was calculated as the sum of the area under the curve for each deceleration. Neonatal birthweights were classified as low (<2500 g), normal (2500–3999 g) or macrosomic (>4000 g). A total of 85 VEs were analyzed. Multivariable linear regression, adjusted for gestational age, nulliparity and diabetes mellitus, revealed a negative correlation between TDA in the 60 min preceding delivery and umbilical cord pH. For every 10 K increase in TDA, the cord pH decreased by 0.02 (p = 0.038; 95%CI, −0.05–0.00). The use of the Ventouse-Mityvac cup was associated with a 0.08 de...

This retrospective cohort study assessed the association between nuchal cord and adverse outcomes during vacuum-assisted delivery (VAD). Women with singleton pregnancies, 34–41-weeks gestation, who underwent VAD, from 2014 to 2020 were included. The primary outcome was umbilical cord pH ≤ 7.1. Secondary outcomes were neonatal intensive care unit admission, Apgar scores, pH < 7.15, subgaleal hematoma, shoulder dystocia and third/fourth-degree perineal tear. Outcomes were compared between neonates with (1059/3754, 28.2%) or without (71.8%) nuchal cord after VAD. No difference in cord pH ≤ 7.1 was found between groups. The nuchal cord group had a lower rate of nulliparity (729 (68.8%) vs. 2004 (74.4%), p = 0.001) and higher maternal BMI (23.6 ± 4.3 vs. 23.1 ± 5, p = 0.017). Nuchal cord was associated with higher rates of induction (207 (19.5%) vs. 431 (16%), p = 0.009) and lower birthweights (3185 ± 413 vs. 3223 ± 436 g, p = 0.013). The main indication for VAD in 830 (80.7%) of the ...

A lesão medular é incapacitante, irreversível e de custo econômico e social elevado. Neste estudo, objetivou-se padronizar um modelo de lesão medular, que produza paraplegia, com o uso de cateter e avaliar histologicamente a efetividade da lesão para estudos com terapia celular. Foram realizadas as lesões medulares em ratos Wistar, utilizando-se o cateter Fogarty n.3 e compressão na região toracolombar (T8-T9) durante 5 minutos. Foram estudados três grupos: grupo A, animais controle sem lesão medular; grupo B, animais submetidos à lesão, utilizando-se 50µL de compressão; grupo C, animais submetidos à lesão, utilizando-se 80µL de compressão. Foi realizada avaliação motora pela aplicação da escala BBB, antes da compressão, após recuperação anestésica, 24 e 72 horas depois da compressão e sete dias após a compressão. Após o sétimo dia da lesão, os animais foram submetidos à eutanásia, foi feita a retirada da medula espinhal, fígado e rins e realizada a análise histológica com a coloraç...

Background A few published data on maternal and cord levels of zinc and copper with conflicting results were reported. We aimed to measure zinc and copper levels in the maternal blood and cord blood of newborns and correlate their levels with the gestational age and anthropometric measurements. This cross-sectional study included 75 full-term and preterm neonates and their mothers. These neonates were divided into 2 groups according to their gestational age. Serum levels of copper and zinc were estimated for the mothers of the studied neonates as well as their cord samples. This was done using atomic absorption spectrophotometry. Results The mean cord serum zinc in full term was 0.88 ± 0.18 μg/ml whereas in preterms was 0.73 ± 0.13 μg/ml. The mean cord copper in full term was 1.37 ± 0.26 μg/ml, whereas in preterms was 0.75 ± 0.28 μg/ml. Comparison between cord zinc and copper levels and maternal levels were statistically significant (p < 0.001). A significant positive correlation...