Pathologie der Schwangerschaft, der Plazenta und des Neugeborenen

Vogel, Martin

doi:10.1007/978-3-642-59231-7_3

Cited by 4 publications

(6 citation statements)

References 115 publications

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“…Lethal complications involving the umbilical cord are found in 7.7-11.4% of stillbirths and 0.06% of all pregnancies [7,14,16].…”

Section: Discussionmentioning

confidence: 99%

“…2) are seen in 30-50% of pregnancies with no known risk factors [14]. These are mainly variations of the normal condition in which the site of insertion is paracentral and complications are rare.…”

Section: Variations In Insertion Of the Umbilical Cordmentioning

confidence: 99%

“…The lack of Wharton's jelly, therefore, produces a situation similar to that in velamentous insertion or aberrant vessels that is accompanied by a risk of vascular rupture as a result of fetal movements. The insertion itself may be central, paracentral, marginal, or velamentous with combinations of these also being possible [10,14].…”

Section: Variations In Insertion Of the Umbilical Cordmentioning

confidence: 99%

“…More than half (50.5-59.0%) of the cases of IUFD due to natural causes occurred as a result of anoxia associated with a disturbance of placental function, i.e., acute or chronic placental insufficiency [7,14,16]. Infection (2.1-21.0%) and congenital abnormalities and malformation (11.4-13.4%) are also common causes.…”

Section: Introductionmentioning

confidence: 99%

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Sudden intrauterine death associated with furcate insertion of the umbilical cord

Laberke

Deubler

2008

Int J Legal Med

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In the case described, a completely uncomplicated pregnancy ended with a fatal outcome. Intrauterine fetal death, which was diagnosed prepartum at 40 weeks of gestation, was caused by hemorrhage of the fetus into the amniotic fluid following rupture of the umbilical vein at the site of furcate insertion of the umbilical cord. This insertion anomaly accompanied by rupture of a vessel occurs only very rarely but represents a placental cause of an abrupt and unpredicted end of a pregnancy. Although this process involved trauma, from a medico-legal point of view, there was no sign of external impact and death could, therefore, be classified as natural.

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“…Lethal complications involving the umbilical cord are found in 7.7-11.4% of stillbirths and 0.06% of all pregnancies [7,14,16].…”

Section: Discussionmentioning

confidence: 99%

Section: Variations In Insertion Of the Umbilical Cordmentioning

confidence: 99%

Section: Variations In Insertion Of the Umbilical Cordmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Sudden intrauterine death associated with furcate insertion of the umbilical cord

Laberke

Deubler

2008

Int J Legal Med

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“…Today, however, these combined findings can only be seen rarely, a change that has probably resulted from the introduction of a strict metabolic regime for women with diabetes mellitus requiring insulin support. The placenta is considered to be of enlarged size when the weight and the basal plate are above the 90th percentile with respect to the week of pregnancy at birth [50][51][52]. Today, this enlarged size is rarely seen, and when it is diagnosed it is usually in diabetes stages White A, B and C accompanied by an inadequate metabolic regime.…”

Section: The Placenta In Overt Diabetes Mellitusmentioning

confidence: 99%

Morphological Findings in Infants and Placentas of Diabetic Mothers

Kos¹,

Vogel²

2005

Frontiers in Diabetes, 2005

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Infants of diabetic mothers have many problems, usually called diabetic embryopathy, i.e. fetopathy. Congenital malformations together with spontaneous abortions are usually summarized under the term diabetic embryopathy, while the term diabetic fetopathy encompasses increased incidence of perinatal death, increased somatic size (macrosomia) and hypertrophy of the islets of Langerhans with B cell hyperplasia and hyperinsulinaemia. Before the discovery of insulin and its widespread use in every day practice, many infants, but their mothers as well, have died during pregnancy complicated with diabetes. Close surveillance of diabetic pregnancy has resulted in a decrease of overall perinatal mortality to 2.8%, and even to less than 2% [1-3]. These figures are still 2-to 3-fold greater than in uncomplicated pregnancies. The risk of a lethal outcome for the infant depends upon the duration and intensity of the mother's diabetes and also upon the degree of blood vessel damage it has caused. Increased perinatal mortality is the result of both increased intrauterine and neonatal mortality. Thirty years ago the main causes of neonatal death in infants from diabetic pregnancies were extreme prematurity, hyaline membrane disease, pulmonary changes unrelated to hyaline membranes, congenital malformations, infections (lung infections excluded) and changes due to asphyxia [3]. Despite many advances in the last 30 years, the rate of early and late fetal death and of neonatal mortality still remains higher than in uncomplicated pregnancies [2, 4-9]. The increased risk of fetal death begins during the third trimester, increasing gradually between 30 and 40 weeks' gestation. The autopsy of stillborn infants often fails to reveal the cause of death [10]. Experiments have shown that hyperglycaemia in lambs causes hyperinsulinaemia, increased basal metabolism and hypoxaemia. We can assume that a similar reaction in human Downloaded by: Univ. of California San Diego 198.143.33.65 -8/19/2015 12:47:14 PM Kos/Vogel 128fetuses leads to an increase in cardiac output and an abundant norepinephrine excretion together with a decrease in glucagon secretion. This pathophysiological mechanism may in humans also be the cause of unexplained intrauterine deaths in diabetic pregnancies [11]. However, strict control of maternal glycaemia has significantly reduced the stillbirth rate. In diabetic pregnancies there exists an increased risk of most congenital malformations, and the term 'diabetic embryopathy and fetopathy' has been long known in medicine [12]. In a large retrospective study carried out in Washington State, USA, the prevalence of congenital malformations was compared in infants of mothers with established pre-existing diabetes, gestational diabetes and the non-diabetic control group. In infants of mothers with pre-existing diabetes the prevalence of congenital malformations was 7.2%, in those of mothers with gestational diabetes 2.8%, while it was 2.1% in infants of healthy mothers [5]. These results differ from the results of studies in ...

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