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Обвитие пуповиной
Здравствуйте уважаемые коллеги. У нас погиб ребёнок в родах. Самая вероятная причина обвитие пуповиной во втором периоде и острая гипоксия. Прошу помощи в изучении статистики по данной проблеме. Обратило на себя внимание скудное развитие Вартониева студня по этой теме вообще ничего не нашёл. Буду благодарен за ссылки и личный опыт.
Андрей Владимирович Алексеев. |
#2
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Histopathology of placental disorders
Author Drucilla J Roberts, MD Section Editors Charles J Lockwood, MD Rochelle L Garcia, MD Deputy Editor Vanessa A Barss, MD Disclosures All topics are updated as new evidence becomes available and our peer review process is complete. Literature review current through: Jun 2013. | This topic last updated: янв 28, 2013. Цитата:
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Gross examination of the placenta
Author Drucilla J Roberts, MD Section Editors Charles J Lockwood, MD Rochelle L Garcia, MD Deputy Editor Vanessa A Barss, MD Disclosures. All topics are updated as new evidence becomes available and our peer review process is complete. Literature review current through: Jun 2013. | This topic last updated: янв 28, 2013. Цитата:
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Продолжение
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Недостаточность Вартониева студня
INADEQUATE WHARTON'S JELLY — The amount of Wharton’s jelly is assessed by visualizing a mid segment of the umbilical cord in cross section, measuring the area using the software of the ultrasound machine, and then comparing the measurement with an established umbilical cord area nomogram. Thin cords have vessels that are more vulnerable to compression and have been associated with intrauterine growth restriction and fetal distress during labor.
Sonographic umbilical vessel morphometry and perinatal outcome of fetuses with a lean umbilical cord.Ghezzi F, Raio L, Günter Duwe D, Cromi A, Karousou E, Dürig PSOJ Clin Ultrasound. 2005;33(1):18. PURPOSE: This study was undertaken to assess whether changes in umbilical cord vessel morphometry are associated with an increased risk of adverse perinatal outcome among fetuses with a lean umbilical cord on sonography. PATIENTS AND METHODS: A total of 160 fetuses with a sonographically lean umbilical cord (cross-sectional area below the 10th percentile for gestational age) after 20 weeks of gestation were enrolled. The cross-sectional areas of the umbilical cord and its vessels were measured. Outcome variables investigated were perinatal death, admission to the neonatal intensive care unit, intrauterine growth restriction, and 5-minute Apgar score. RESULTS: The proportions of perinatal death (1/96 versus 6/64, p<0.05) and admission to the neonatal intensive care unit (17/96 versus 22/64, p<0.05) was significantly higher among fetuses with an umbilical vein area below or equal to the 10th percentile for gestational age than among those with an umbilical vein area greater than the 10th percentile. No differences were found in the proportions of perinatal death, neonatal intensive care unit admission, 5-minute Apgar score<7, and intrauterine growth restriction when fetuses with umbilical vein areas below or equal to the 10th, the 5th, and the 2.5th percentiles for gestational age were compared. No difference was found in the umbilical artery area and Wharton's jelly area among the groups. CONCLUSION: Among fetuses with a sonographically lean umbilical cord, a significant relationship exists between an umbilical vein area below or equal to the 10th percentile and an adverse neonatal outcome. Department of Obstetrics and Gynecology, University of Insubria-Del Ponte Hospital, Piazza Biroldi 1, 21100 Varese, Italy. Sonographic measurement of the umbilical cord and fetal anthropometric parameters.Raio L, Ghezzi F, Di Naro E, Gomez R, Franchi M, Mazor M, Brühwiler H Eur J Obstet Gynecol Reprod Biol. 1999;83(2):131. OBJECTIVE: To determine reference ranges for the diameter and the cross-sectional area of the umbilical cord during pregnancy and to determine if umbilical cord morphometry is related to fetal size. METHODS: A prospective cross-sectional study was designed to assess the sonographic cross-sectional diameter and area of the umbilical cord. The sonographic umbilical cord measurements were obtained in a plane adjacent to the insertion of the cord into the fetal abdomen. Nomograms for the umbilical cord diameter and area were computed. Fetal biometry included: biparietal diameter, abdominal circumference, and femur length. Polynomial regression analysis was conducted. RESULTS: Five hundred and fifty seven patients were included into the study. The regression equation for the umbilical cord diameter (y) according to gestational age (x) was y=-10.0563+1.4265x+0.0194x2 and for the umbilical cord area (y') was y'=91.6-3.3x+0.03x2-0.00007x3. A significant relationship was found between umbilical cord measurements and fetal anthropometric parameters. CONCLUSION: Reference ranges for umbilical cord diameter and area have been generated. The sonographic diameter and cross-sectional area of the umbilical cord increase as a function of gestational age and both diameter and area correlate with fetal size. The Department of Obstetrics and Gynecology, Kantonsspital, Münsterlingen, Switzerland. |