Neonatal lupus syndrome (NLS) is a rare, passively acquired autoimmune syndrome caused by maternal autoantibodies. We describe a case of a newborn with NLS and the accompanying placental findings. A female neonate was born by emergency cesarean delivery due to non-reassuring fetal status at 35 weeks and 3 days. This neonate had congenital erythematous and scar lesions on the face, back, and upper and lower extremities. Maternal and fetal anti-SSA and SSB antibodies were elevated and this baby was diagnosed as NLS. Histologically, the chorionic villi demonstrated capillary shrinkage. An immunohistochemical study revealed complement deposition (C4d) in the capillaries of the villi and umbilical vessels. Our findings suggest that maternal autoantibodies affect the inflammatory response of the fetus through the placenta and that C4d deposition may be useful for diagnosing NLS.
Objectives: A number of placenta abnormalities may cause fetal growth restriction, which is assumed to be due to uteroplacental insufficiency. We discussed the correlation between 2D ultrasound images and pathological findings of the placenta with early-onset severe fetal growth restriction (FGR). Methods: This was a retrospective study performed at a single tertiary perinatal centre. Two obstetrical specialists and one pathologist reviewed medical records. Severe FGR was defined as estimated fetal body weight with less than 3rd percentile based on the guideline by the Japanese Society of Ultrasonics in Medi. Results: In some cases with early-onset severe FGR, huge fluid-like images were observed among placental villi. Their pathological findings were reported to be intervillous fibrin deposition or villitis of unknown etiology in 75%. Conclusions:The huge fluid-like area in the placenta could be linked to histological findings of intervillous fibrin deposition or villitis of unknown etiology and may cause early-onset severe FGR.Supporting information can be found in the online version of this abstract Objectives:To investigate the use of fetal cerebroplacental ratio (CPR) to identify placental vascular malperfusion. Methods: 65 full-term pregnant women were studied prospectively in the third trimester of pregnancy. Doppler ultrasound examination of umbilical artery (UA), middle cerebral artery (MCA), and uterine artery (UtA) was performed at 35-40 gestational weeks. The pulsatility index (PI) was calculated. The CPR was calculated as the ratio between the MCS PI and the UA PI. All Doppler indices were converted into multiples of median (MoM), correcting for gestational age using reference ranges. Histological characteristics of placentas were classified as normal, histological chorioamnionitis, and vascular underperfusion. Results:The CPR values of fetuses were not significantly associated with abnormal pathologic findings. Fetuses with an abnormal CPR value were significantly more likely to have an adverse composite perinatal outcome and higher rates of Caesarean delivery. Cord gas analysis was not associated with low CPR value. Conclusions: A low CPR was associated with increased rates of adverse composite perinatal outcome, but not associated with abnormal pathologic findings. Objectives: To assess the possibilities of three-dimensional (3D) ultrasound in the prenatal diagnosis of true knots of the umbilical cord. Methods: A prospective longitudinal study was performed in MC ''Markovs'', Sofia from Sep 2011 to Oct 2016. Overall 7 cases of true knots of the umbilical cord were identified. Conventional 2D and Colour Doppler ultrasound was performed in order to screen for true knots of the umbilical cord. Whenever a true knot was suspected several 3D volumes with and without Colour/Power Doppler of the region of interest were acquired. The clinical relevance of each volume data set was analysed off-line with specialised software (4D View, GE Healthcare). Results: There were 7 cases of prenatally diagnosed true...
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