Introduction !The umbilical cord (UC) is the essential life-sustaining connection between fetus and placenta. It constitutes a stable connection to the fetomaternal interface, while allowing fetal mobility that is essential for fetal development in general and neuromotor development in particular. This combination of mechanical stability and flexibility is due to the architecture of the UC. There is however a range of umbilical cord complications that may be life threatening to the fetus, and these too can be explained to a large extent by the cordʼs structural characteristics. Examination of cord vessels using Doppler ultrasound enables investigators to deduce the state of the fetoplacental vascular bed, providing essential information on the condition of the fetus. Development and Architecture of the Umbilical Cord !In its embryonic stage the UC develops in the region of the body stalk to become the embryoʼs connection to the fetal portion of the placenta (fetal placenta). The amniotic cavity expands from dorsal to ventral while the chorionic cavity shrinks in volume. During cephalo-caudal and lateral folding the early UC arises as it is "enveloped" by the expanding amnion (l " Fig. 1) (see also textbooks of embryology, www.embryology.ch). In this early stage at around 7-8 weeks postmenstrual age the UC contains the body stalk with umbilical vessels as well as other structures that will later regress and disappear entirely: the allantoic diverticulum (an outpouching from the endoderm connected to the (future) urinary bladder, later the urachus), as well as the extra-embryonic coelom that at this early stage still forms a connection to the cho- Abstract !The umbilical cord (UC) is a vital connection between fetus and placenta. It constitutes a stable connection to the fetomaternal interface, while allowing the fetal mobility that is of great importance for fetal development in general and fetal neuromotor development in particular. This combination of mechanical stability and flexibility is due to the architecture of the UC. There is however a range of umbilical cord complications that may be life threatening to the fetus and these too can be explained to a large extent by the cordʼs structural characteristics. This review article discusses clinically relevant aspects of UC ultrasound. Zusammenfassung !Die Nabelschnur ist die lebenswichtige Verbindung zwischen Fetus und Plazenta. Sie bildet einerseits eine stabile Verbindung zur zentralen Einheit des fetomaternalen Stoffwechsels und ermöglicht dem Feten andererseits eine Beweglichkeit, die für die körperliche -insbesondere die neuromotorische -Entwicklung von großer Bedeutung ist. Diese Kombination aus mechanischer Stabilität und Flexibilität begründet sich in der Architektur der Nabelschnur. Es gibt jedoch eine Reihe an Nabelschnurkomplikationen, die den Feten z. T. lebensbedrohlich gefährden können. Auch diese lassen sich vor allem auf die strukturellen Eigenschaften der Nabelschnur zurückfüh-ren. Im Rahmen einer Übersichtsarbeit werden klinisch relevante Asp...

Diagnosis of APVS is feasible within first trimester. Outcomes remain guarded, especially if first trimester diagnosis is included into the analysis because of associated karyotypic anomalies, the presence of hydrops fetalis, and patent ductus arteriosus. © 2017 John Wiley & Sons, Ltd.

In acute respiratory distress syndrome (ARDS) with pulmonary hypertension, interleukin-1 beta (IL-1 beta) and interleukin-8 (IL-8) are involved in the pulmonary inflammatory reaction. The purpose of this study was to determine whether systemic and aerosolized administered IL-1 receptor antagonist (IL-1Ra) Anakinra (Kineret) improves lung mechanics and pulmonary artery pressure in surfactant depleted newborn piglets. After induction of acute lung injury by lung lavage, neonatal piglets received repetitive treatment of either aerosolized IL-1Ra (IL-1Ra-Aerosol) or intravenous IL-1Ra (IL-1Ra-i.v.), or saline solution as control. IL-1Ra given as aerosol or intravenously significantly reduced mean pulmonary artery pressure (MPAP) but did not influence mean systemic arterial pressure (MAP) compared with the control group. IL-1 beta and IL-8 mRNA expressions normalized to beta-actin and hypoxanthine-guanine-phosphoribosyl transferase were significantly reduced in the IL-1Ra-Aerosol group but not in IL-1Ra-i.v. group compared to the control group. The lung injury score was not significantly different between IL-1Ra groups and the control group. Application of aerosolized IL-1Ra reduced MPAP without affecting MAP in a piglet model of surfactant depletion with pulmonary hypertension. Furthermore, there is evidence for reduction of early pro-inflammatory pulmonary reaction.