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Re: umbilical vein vs umbilical artery thrombusFrom: James S Smeltzer MD (gaperina@mindspring.com)Tue Aug 25 09:55:59 1998
At 08:51 PM 8/24/1998 -0500, you wrote: >I was called to the Birthing Center today for possible fetal demise, >which was verified by m-mode. It was a very quick scan as patient was >hysterical, but happened to see umbilical cord with echogenic material >within in it. My first thought was umbilical vein thrombosis, but on a >transverse view of the cord, two structures appeared to be echogenic, >and only one sonolucent. > >Is it possible for both umbilical arteries to thrombose? How long after >a demise would that take place? > >I have not been able to find anything on UA thrombosis. There is a short >reference and one image in Callen second edition for UV thrombosis. I >just attempted a medline search, but didn't get much info and got a few >ERROR messages. NOt sure if that was me or my Mac :( > >Also, patient appeared to have a retroplacental abruption. Placenta was >very thick, and non-homogeneous. But, patient denies any pain or >bleeding. We have no previous studies. > >Any ideas or references? > >Thanks, > >Barbara, RDMS > If at the cord root, small omphalocele, with aneuploidy until proven otherwise. Corangioma, hydropic cord with bullae. Postmortem US is pretty unrevealing. It is better to alert the OB, and the fetus, cord and placenta need path evaluation. What about the baby and placenta? If fluid, an amniocentesis has a higher yield for chromosomes than anything from the fetus. Jim S
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