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At least 19 recordsLinked to original sources
PubMed2000

The relationship among inflammatory lesions of the umbilical cord (funisitis), umbilical cord plasma interleukin 6 concentration, amniotic fluid infection, and neonatal sepsis.

OBJECTIVE: The purpose of this study was to determine whether funisitis (inflammation of the umbilical cord detected by histologic examination of the placenta) is associated with changes in the umbilical cord plasma concentration of interleukin 6, microbial invasion of the amniotic cavity, and neonatal sepsis. STUDY DESIGN: The relationship among the presence of funisitis, interleukin 6 concentrations in umbilical cord plasma at birth, the results of amniotic fluid culture performed within 3 days of birth, and the occurrence of congenital neonatal sepsis was examined in 315 consecutive singleton preterm births (20-35 weeks' gestation). Funisitis was diagnosed in the presence of neutrophil infiltration into the umbilical vessel walls or Wharton jelly. The interleukin 6 concentration was measured with a specific immunoassay. Amniocentesis was performed in 106 patients within 3 days of birth. Amniotic fluid was cultured for aerobic and anaerobic bacteria and for mycoplasmas. RESULTS: (1) Funisitis was present in 25% of patients (78/315). (2) Patients with funisitis had a significantly higher median cord plasma interleukin 6 and a lower gestational age at birth than did those without funisitis (cord interleukin 6: median, 52.4 pg/mL; range, 0.9-19,230 pg/mL; vs median, 4.6 pg/mL; range, 0-18,108 pg/mL; gestational age: median, 31.1 weeks' gestation; range, 21.0-35.0 weeks' gestation; vs median, 32.9 weeks' gestation; range, 21.4-35.0 weeks' gestation; P<.001 for each comparison). (3) A cord plasma interleukin 6 of > or =17.5 pg/mL had a sensitivity of 70% and a specificity of 78% in the identification of funisitis. (4) Microbial invasion of the amniotic cavity and clinical chorioamnionitis were more common among patients with funisitis than among those without funisitis (positive amniotic fluid culture: 53% [20/38]; vs. 12% [8/68]; clinical chorioamnionitis: 18% [14/78]; vs. 4% [9/237]; P<.001 for each comparison). (5) Neonates with funisitis had a significantly higher rate of congenital sepsis than did those without this lesion (12% [8/66] vs. 1% [3/216]; P<.001); this difference remained significant after adjustment for gestational age at birth (odds ratio, 7.2; 95% confidence interval, 1.8-29.0). CONCLUSION: (1) Umbilical cord plasma interleukin 6 concentrations were higher in neonates born with funisitis than in those without this lesion. (2) Funisitis is associated with amniotic fluid infection, congenital neonatal sepsis, and the fetal inflammatory response syndrome.

Adult↗
PubMed1987

Atenolol and short umbilical cords.

Umbilical cord length may be a function of fetal movement. Agents that cause decreased fetal movement may cause short umbilical cords. This investigation examined the effect of the beta-blocker atenolol on umbilical cord length in rabbits. Fetuses of rabbits treated with atenolol had significantly shorter cords than control animals (p less than or equal to 0.0005). Since short cords are associated with problems in labor, low Apgar scores, and abruption, we recommend careful surveillance of mothers and fetuses who are given beta-blocking agents in the first 30 weeks of pregnancy.

Animals↗
PubMed1997

[Cardiotocographic changes after umbilical cord puncture and umbilical cord transfusion].

In connection with umbilical cord punctures and transfusions the degree of pathology still tolerable after these procedures as well as the influence on subsequent obstetric management has to be discussed. In a prospective study we evaluated 98 cordocenteses with (n = 44) and without (n = 54) transfusion (25-37 week of gestation). 30-160 ml of blood were transfused. In all cases the umbilical vein was punctured at the point of insertion into the placenta (46x posterior and 52x anterior wall placenta). A CTG was performed prior and after the punction and was evaluated according to the Fischer score. After the procedure, the course of pregnancy was normal in all puncture patients and in 52 of 54 patients who also underwent a transfusion. Because of a pathological CTG due to a severely hydroptic fetus, a caesarean section had to be performed in one woman seven hours after umbilical cord transfusion. In another patient an emergency section was necessary immediately after the umbilical cord transfusion, due to persistent fetal bradycardia. In the puncture group mean Fischer score values decreased from 9.1 to 7.5, in the transfusion. In another patient an emergency section was necessary immediately after the umbilical cord transfusion, due to persistent fetal bradycardia. In the puncture group mean Fischer score values decreased from 9.1 to 7.5, in the transfusion group from 8.6 to 7.4. The results were more unfavorable when amplitude and occurrence of accelerations were considered, especially in the transfusion group. In one fifth of the puncture cases and one fourth of the transfusion patients the criterium of baseline crossings improved after the procedure. In summary, a pathological CTG is to be expected after umbilical cord punctures and transfusions, with however, only the necessity of surveillance. Only in cases of persistent fetal bradycardia an active obstetric management is indicated.

Blood Transfusion, Intrauterine↗
PubMedDate not supplied

Sonographic evaluation of umbilical cord insertion with umbilical coiling index.

PURPOSE: The aim of this study was to investigate the association between umbilical cord hypocoiling and abnormal placental insertion of the umbilical cord. METHODS: Umbilical coiling was measured by sonography in 253 pregnant women in their second or third trimester. An umbilical coiling index, defined here as the reciprocal of the length of 1 umbilical vascular coil, of less than 0.1 was considered hypocoiled. The distance from the placental edge to the insertion of the umbilical cord was measured after delivery, and the results were used to classify cord insertion as normal, marginal, or velamentous. RESULTS: Cord insertion was abnormal in 66.7% of the fetuses with umbilical hypocoiling but in only 1.3% of those whose coiling index was > or = 0.1 (p < 0.05). CONCLUSIONS: Hypocoiling of the umbilical cord was highly associated with abnormal cord insertion. The presence of a hypocoiled umbilical cord may indicate the presence of abnormal cord insertion and thus may be useful for obstetric management.

Adult↗
PubMed1998

[Umbilical cord blood transplantation: acceptance of umbilical cord blood donation by pregnant patients].

BACKGROUND/OBJECTIVE: Umbilical cord blood is an alternative source for allogeneic transplantation of hematopoietic stem cells from related and unrelated donors. It can easily be collected, cryopreserved and stored in cord blood banks for later use. In Switzerland, cord blood banks for related and unrelated stem cell transplantation are being established. The aim of the study was to evaluate previous knowledge of the possible medical use of cord blood and acceptance of cord blood banking in pregnant women. METHODS: We performed a prospective open study using a structured, anonymous questionnaire at the University of Basel Women's Hospital pregnancy outpatient clinic. After concise information on the use of cord blood for transplantation, questions were asked concerning previous knowledge of the use of placenta and cord blood in general, concerning the attitude to donation of cord blood for transplantation, and the respondent's willingness to donate cord blood of her own child. Women of different ethnic background were compared. RESULTS: From 300 questionnaires handed out to pregnant women of different ethnic background attending our outpatient clinic, 250 (83%) were returned, and 245 could be evaluated for final analysis. Only 40% indicated that they did know what usually happens to the placenta after birth. In contrast, the vast majority (95%) supported the idea of umbilical cord blood for banking and later use for stem cell transplantation. Similarly, 93% stated that they would agree to donate the cord blood from their own child for this purpose, while no statistically significant differences could be identified either between women with or without previous knowledge or of different ethnic background. CONCLUSIONS: This study shows the high acceptance of umbilical cord blood donation for banking and stem cell transplantation purposes in pregnant women, irrespective of previous knowledge. As there are no major differences between women of different ethnic background, a high degree of diversity of HLA-types of donated cord blood samples can be expected and may offset the underrepresentation of ethnic minorities in bone marrow donor registries.

Blood Banks↗
PubMed2004

Mitochondrial damage and DNA depletion in cord blood and umbilical cord from infants exposed in utero to Combivir.

OBJECTIVE: Although most uninfected infants born to women infected with HIV-1 show no clinical evidence of mitochondrial compromise, mitochondrial dysfunction has been reported in children born to women receiving zidovudine and/or lamivudine during pregnancy. In this pilot study we examined mitochondrial integrity in HIV-1-uninfected infants born to HIV-1-infected women receiving Combivir during pregnancy. DESIGN: : Samples of umbilical cord and cord blood were obtained from HIV-1-uninfected infants born to either HIV-1-infected women receiving Combivir therapy during pregnancy (n = 10) or HIV-1-uninfected women (n = 9). METHODS: Mitochondrial morphological integrity was examined in umbilical cords (n = 16) by electron microscopy and mtDNA quantity was determined in DNA from cord blood (n = 18) and umbilical cord (n = 18) by PCR-chemiluminescence immunoassay detection. RESULTS: In umbilical cords from six of nine infants born to HIV-1-infected mothers taking Combivir moderate to severe mitochondrial morphological damage was observed (P = 0.011), while none of seven unexposed infants showed similar damage. Compared to unexposed infants, statistically significant mtDNA depletion was observed in umbilical cord (P = 0.006) and cord blood (P = 0.003) from drug-exposed infants. CONCLUSIONS: A cohort of HIV-1-uninfected Combivir-exposed infants with no clinical symptoms showed morphological and molecular evidence of mitochondrial damage.

Anti-HIV Agents↗
PubMed1999

Evidence for the presence of luteinizing hormone-chorionic gonadotrophin receptors in the pig umbilical cord.

Pig umbilical cord, like that of humans, contains two arteries and a vein surrounded by Wharton's jelly with amnion covering the exterior surface. The aim of the present study was to investigate whether LH-hCG receptors are present in the pig umbilical cord, using light microscope immunohistochemistry, semiquantitative autoradiography, western blotting and reverse transcription-polymerase chain reaction. Umbilical cords were collected on days 48, 71 and 103 of fetal life (n = 6). Monoclonal and polyclonal anti-LH receptor antibodies were used to study receptor distribution. Immunoreactivity was observed in the umbilical blood vessels, the epithelium of umbilical amnion and cells in the Wharton's jelly. No differences in LH-hCG receptor distribution related to the sex of the fetus, period of fetal life or section of the umbilical cord were observed. Strong immunostaining was observed in umbilical vein and in umbilical arteries. However, in the arteries, the tunica media expressed weaker receptor immunostaining than did the tunica intima and tunica adventitia. No immunoactivity was detected in non-target tissue (skeletal muscle) but LH receptors were immunostained in the pig ovary. Topical autoradiography showed that vein and arteries in the umbilical cord bind 125I-labelled hCG, which was highly diminished after co-incubation with an excess of unlabelled hCG. The binding of 125I-labelled hCG to the Wharton's jelly and epithelial amnion was less intense than it was to vessels. Gonadotrophin binding sites were not present in the skeletal muscle. The pig umbilical arteries, vein and Wharton's jelly contained a 75 kDa immunoreactive LH-hCG receptor protein similar to that found in corpora lutea. Southern blot analysis of reverse transcription-polymerase chain reaction products, performed to enhance the sensitivity and specificity of LH receptor transcripts determination in umbilical cord tissues, revealed that the expected fragments of 740 and 470 bp were present in the arteries, vein, Wharton's jelly and corpora lutea (positive control). An additional product of 670 bp was found in the corpora lutea and arteries of umbilical cord, but not in the vein and Wharton's jelly. This is probably the first reported evidence of the presence of LH-hCG receptors in the umbilical cord of a non-human female mammal.

Amnion↗
PubMed2002

Look before you clamp: delivery room examination of the umbilical cord.

The umbilical cord is a critical connection between the embryo (and later, the fetus) and the placenta. The umbilical cord houses the blood vessels that are responsible for nourishing the fetus. Proper umbilical cord function is essential for growth and development before birth. A review of the embryologic origin of the umbilical cord aids in understanding abdominal wall and umbilical cord defects that can present in the newborn period. In the delivery room, inspection of the umbilical cord is an integral part of the first minutes of life. Any abnormality either within the cord structure or in the areas surrounding the base of the cord may necessitate a delay in shortening the cord. Surgical consultation may also be indicated. This issue of Focus on the Physical will provide a step-by-step guide to cord assessment in the delivery room setting. Pictures showing normal, atypical, and abnormal umbilical cords and common abdominal wall defects will be presented along with a brief discussion of the significance and clinical implications of each of these findings.

Abdominal Wall↗
PubMed2001

Biomechanical properties of the human umbilical cord.

The umbilical cord is a complex and fascinating structure that connects the fetus to the placenta and encases the umbilical vessels. The response of its tissues to mechanical loading due to fetal movements and uterine contractions is not well understood. The aim of this study is the evaluation of the mechanical properties of the main components of the human umbilical cord. Fresh umbilical cord specimens were collected from neonates born at term of the gestation and submitted to compliance tests. Furthermore, uniaxial tensile and stress-relaxation tests were performed on samples of umbilical vein and Wharton's jelly. Both materials exhibited nonlinear stress-strain response with increasing strain, increasing the elastic modulus (E(high) about 10-20 times E(low)) and significant viscoelastic behavior. In addition, anisotropy of the vein was observed. Although the circumferential properties of the vein (mean E(high) about 2.4 MPa) were similar to those after birth, the longitudinal stiffness of both materials was higher (mean E(high) over 10 MPa) and comparable to that of the ligaments. These findings suggest a mechanism of protection acting against excessive elongations of the cord, which could cause undue restriction of the umbilical vessel area and interference with the fetal blood circulation.

Compliance↗
PubMed1977

True knot of the umbilical cord.

Fifty umbilical cords were prepared and examined and their venous perfusion pressures measured with and without a true knot in the cord. Contrary to information in the literature, a loose umbilical cord knot did not affect the venous perfusion pressure. With a tightened knot, the smaller the umbilical cord diameter, the greater was the pressure required to perfuse past the knot. The umbilical vessels, protected by the myxomatous structure of the Wharton's jelly, were rarely completely occluded. These findings correlate clinically with the relatively high incidence yet low fetal mortality rate actually due to a true knot in the umbilical cord.

Female↗