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Re: 35 week fetal demiseFrom: JD Stewart,MD (jdstewartmfmob@sbcglobal.net)Thu Oct 27 16:53:51 2005
At Thu, 27 Oct 2005, Andrew Folley wrote: > >G1P0 35 weeks 20 yo wf, no smoking no drugs, normotensive uncompicated >pregnancy. Baby moving the day before. Rountine exam no FHTs. Echo AFI 6. > Delivered 24 hours later. No anomalies. Thrombosis of cord at insertion >site several cms in length. No knot no cord entaglement no torsion etc. . > Extensive blood tests ordered on mom thrombophilias etc, autopsy on baby >chromosome studies etc. Any thoughts on etiology?????????? andy If the placenta is still available, ask (or see for yourself) if there is a lack of Wharton's jelly around the area of the cord thrombus. If the cord is uncoiled particularly, one can carefully reapproximate the cord as it lay in situ, and discover an occult torsion and occlusion that aren't readily evident on a tabletop exam. Try and purposely place the cord arrangement as if this had happened, and see it it doesn't suddenly fit into place. AFI at 6cm at 35w is suspect of an ongoing, but likely intermittent problem. I'll forward an email provately with an illustration.
-- JD. Stewart, MD MFM up too late all night, every night
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