Spontaneous umbilical cord hematoma is a rare cause of fetal distress and intrauterine fetal death. The perinatal mortality rate approaches 50%. Various causes of the cord hematoma have been suggested as congenital abnormalities, short cord, trauma, cord around neck, torsion, syphilis, or postmature pregnancy. We have experienced one case of the fetal distress from umbilical cord hematoma, which is presented with a brief review of the literatures.
Congenital Abnormalities ; Fetal Death ; Fetal Distress* ; Hematoma* ; Neck ; Perinatal Mortality ; Pregnancy ; Syphilis ; Umbilical Cord*

BACKGROUND: The umbilicus is a simple scar that obliterates the portal through which the omphalomesenteric duct connected the primitive gut to the yolk sac; through which the intestine was expelled prior to its rotation; through which passed the umbilical arteries and vein; at which the allantosis attached to the early urinary bladder; and at which the umbilical cord that carried these structures was fused to the body wall. The umbilicus is situated at the level of L3 to L4 in the midline of the abdomen. It's shape, size, and configuration vary greatly related to age and sex. Deramtoses of the umbilicus are umbilical hernia, congenital abnormalities, granulomas, omphalith, infections, eczema and tumors. OBJECTIVE: The purpose of this study was to examine the umbilical shape and size related to age and sex and diseases of the umbilicus. METHODS: During a 6-month-period from May to October, 1998, 420 person's umbilical shapes and size were examined with regard to age and sex. The diseases of the umbilicus were evaluated, too. RESULTS & CONCLUSIONS: 1. The mean vertical diameter of the umbilicus is 1.89+/-0.65cm and the mean transverse diameter is 1.98+/-0.86cm. The mean diameter of umbilicus in women(vertical: 1.98+/-0.73cm, transverse: 2.07+/-0.99cm) is larger than the mean diameter of umbilicus in men(vertical: 1.80+-0.53cm, transverse: 1.89+/-0.66cm)(p<0.05). 2. The vertical diameter of umbilicus in both sexes showed increasing aspect until the 30-39 year old group, and the transverse diameter of umbilicus in both sexes showed increasing aspect until the 40-49 year old group. 3. The shapes of umbilicus were divided into the protruded type and the depressed type. Most of our cases showed the depressed type. The protruded types were more in the 0-9 year old group(23%) than other year old groups. The shapes of umbilicus were divided into the round type and the elliptical type, too. The elliptical type(transverse diameter>vertical diameter) is more than the elliptical type(vertical diameter>transverse diameter) in men, and the elliptical type(vertical diameter>transverse diameter) is more than the elliptical type(transverse diameter>vertical diameter) in women. 4. The diseases of the umbilicus are allergic contact dermatitis(6 cases), pityriasis rosea(5 cases), psoriasis(3 cases), scabies(3 cases), rhus dermatitis(2 cases), pemphigus(2 cases), drug eruption(1 case), and insect bite(1 case).
Abdomen ; Cicatrix ; Congenital Abnormalities ; Eczema ; Female ; Gastrula ; Granuloma ; Hernia, Umbilical ; Humans ; Insects ; Intestines ; Male ; Pityriasis ; Rhus ; Umbilical Arteries ; Umbilical Cord ; Umbilicus ; Urinary Bladder ; Veins ; Vitelline Duct ; Yolk Sac

A case is presented of an amnionic rupture sequence which led to massive fetal ventral herniation and lordoscoliosis. Characteristic ultrasonographic findings of an omphalocele, fetal attachment to the placenta, and the absence of free-floating umbilical cord were observed.
Abnormalities, Multiple/*etiology/ultrasonography ; Adult ; Amnion ; Female ; Fetal Membranes, Premature Rupture/*complications ; Gestational Age ; Hernia, Umbilical/etiology ; Humans ; Infant, Newborn ; Male ; Pregnancy ; Umbilical Cord/abnormalities

OBJECTIVE: The purpose of this study was to assess the effect of the isolated oligohydramnios on the perinatal outcome in uncomplicated term pregnancies. METHODS: We used data from Jan 2002 to Dec 2005 in all uncomplicated pregnancies between 37 and 41weeks and 6 days of gestation with a singleton fetus, underwent monitoring with serial determination of AFI. Oligohydramnios was defined by ultrasonographic determination of AFI < or =5 cm. Exclusion criteria were PROM, maternal medical complications and fetal anomalies detected by prenatal ultrasound. We investigated the mode of delivery, birth weight, birth weight <10th percentile, 1 and 5 min Apgar score, umbilical cord pH and base excess, and meconium stained amniotic fluid (MSAF). We also assessed the predictive value of obstetric factors associated with adverse perinatal outcome. We used statistics analysis by Chi-square test, independent-samples T test using SPSS 14.0 V. RESULTS: 2,491 patients met our inclusion criteria. Oligohydramnios was diagnosed in 8.63% (215/2,491). There was significantly difference in cesarean section for fetal distress between those with oligohydramnios vs. normal AFI (43.8% vs.4.1%). Patients with oligohydramnios had significantly lower SGA (15.3% vs. 5.7%), lower Apgar score at 1 min<7 (7.9% vs. 3.3%), and higher rate of MSAF (31.2% vs. 18.4%) than those with normal AFI. There were musculoskeletal abnormalities in 10/215 (4.6%) and urogenital abnomralites in 53/215 (24.6%). CONCLUSION: Isolated oligohydramnios in uncomplicated term pregnancies is associated with an increased adverse perinatal outcome. Nulliparity, advanced maternal age, MSAF, SGA, and lower BPP were significantly associated with the adverse perinatal outcomes.
Amniotic Fluid ; Apgar Score ; Birth Weight ; Cesarean Section ; Female ; Fetal Distress ; Fetus ; Humans ; Hydrogen-Ion Concentration ; Maternal Age ; Meconium ; Musculoskeletal Abnormalities ; Oligohydramnios* ; Parity ; Pregnancy ; Pregnancy* ; Ultrasonography ; Umbilical Cord

BACKGROUNDUmbilical cord around neck, a common obstetric complication, affects fetal hemodynamics. Does it influence fetal cardiac functions? The purpose of this study was to investigate the left and right ventricular systolic and diastolic functions of fetuses with umbilical cord around neck in the third trimester by applying velocity vector imaging (VVI).

METHODSThirty-five cases of fetuses with umbilical cord around neck whose gestational ages from 35 to 40 weeks were selected, including 20 cases of umbilical artery ratio of the highest systolic velocity (S) to the lowest diastolic velocity (D) (S/D) < 3.0 and 15 cases of umbilical artery S/D ≥ 3.0, while 20 cases of normal fetuses of 35 - 40 gestational weeks were selected as the control group. The changes in longitudinal velocity, strain, and strain rate of fetal left and right ventricle in systole and diastole in two groups, and the changes in fetal cardiac function under the situation of umbilical cord around neck were analyzed.

RESULTSLongitudinal strain and strain rate overall of fetal left and right ventricle in systole and diastole were less in fetuses with umbilical artery S/D (3)3.0 and umbilical cord around neck than those in fetuses with umbilical artery S/D < 3.0 and those in control group (P < 0.05); there was no significant difference (P > 0.05) in longitudinal strain and strain rate overall of fetal left and right ventricle in systole and diastole between fetuses with umbilical artery S/D < 3.0 and those in control group.

CONCLUSIONSLeft and right ventricular systolic and diastolic dysfunction was detected in fetuses with umbilical cord around neck and umbilical artery S/D (3)3.0. VVI could sensitively respond to cardiac function changes in fetuses with umbilical cord around neck, which provides another valuable method in the evaluation of fetal cardiac function.

Adult ; Female ; Fetus ; abnormalities ; physiopathology ; Gestational Age ; Heart Ventricles ; diagnostic imaging ; pathology ; physiopathology ; Humans ; Myocardium ; pathology ; Pregnancy ; Pregnancy Complications ; Ultrasonography, Prenatal ; Umbilical Arteries ; diagnostic imaging ; pathology ; physiopathology ; Umbilical Cord ; diagnostic imaging ; physiopathology ; Young Adult

BACKGROUND: Umbilical cord blood (UCB) has been increasingly utilized for reconstituting hematopoiesis in a variety of congenital disorders and hematologic malignancies. In this report, we evaluated the maximum collection volume, the efficacy of red cell depletion, cell viability and phenotypic analysis before and after cryopreservation. METHODS: Forty units of UCB (17 from NSVD and 23 from cesarean section) were collected into blood donation bag with ACD-A. Red cells were depleted using 3% gelatin sedimentation or buffy coat separation. UCB units were cultured in methylcellulose media, and phenotypic analyses were performed with monoclonal antibodies for CD34, HLA-DR, CD38, CD13, CD33, c-kit, CD45/CD3, CD45/CD19, CD3/CD4, CD3/CD8. RESULTS: The mean volume of one unit of UCB was 109.2 +/- 32.5 mL and one unit contained 1.20 +/- 0.51x19(9) nucleated cells. Cell counts after red cell depletion by 3% gelatin sedimentation or buffy coat separation revealed recovery rates of 77.5 +/- 14.9% and 64.5 +/- 7.4%, respectively. Cell viabilities and the number of colony forming units - granulocyte and monocyte from fresh and cryopreserved UCB were were 98.1 +/- 1.6%, 88.7 +/- 4.8%, and 6.48 +/- 2.14x10(5), 7.35 +/- 0.65x10(5). The mean percentage of CD34+ cells was 1.02 +/- 1.6% and those of CD34+/HLA-DR+, CD34+/CD38+, CD34+/CD13+, CD34+/CD33+, CD34+/c-kit+ cells were 68.6%, 58.0%, 5.6%, 46.8%, and 29.8%, respectively. Lymphocyte subsets were composed of CD45+/CD3+ (59.0%), CD45+/CD19+ (13.8%), CD3+/CD4+ (42.7%), and CD3+/CD8+ cells (17.1%). There was no significant difference in phenotypic characteristics between fresh and cryopreserved UCB. CONCLUSION: We established the protocols for UCB collection, red cell depletion, cryopreservation, culture and phenotypic analyses. These results would be very useful for future UCB transplantation and preservation/storage.
Antibodies, Monoclonal ; Blood Donors ; Cell Count ; Cell Survival ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Cryopreservation* ; Fetal Blood* ; Gelatin ; Granulocytes ; Hematologic Neoplasms ; Hematopoiesis ; HLA-DR Antigens ; Humans ; Lymphocyte Subsets ; Methylcellulose ; Monocytes ; Stem Cells ; Umbilical Cord*

Deformities in tissues and organs can be treated by using tissue engineering approach offering the development of biologically functionalized scaffolds from a variety of polymer blends which mimic the extracellular matrix and allow adjusting the material properties to meet the defect architecture. In recent years, research interest has been shown towards the development of chitosan (CS) based biomaterials for tissue engineering applications, because of its minimal foreign body reactions, intrinsic antibacterial property, biocompatibility, biodegradability and ability to be molded into various geometries and forms thereby making it suitable for cell ingrowth and conduction. The present work involves the fabrication of nanofibrous scaffold from CS and poly(vinyl alcohol) blends by free-surface electrospinning method. The morphology and functional characteristics of the developed scaffolds were assessed by field emission scanning electron microscopy and fourier transformed infra-red spectra analysis. The morphological analysis showed the average fiber diameter was 269 nm and thickness of the mat was 200–300 µm. X-ray diffraction study confirmed the crystalline nature of the prepared scaffolds, whereas hydrophilic characteristic of the prepared scaffolds was confirmed by measured contact angle. The scaffolds possess an adequate biodegradable, swelling and mechanical property that is found desirable for tissue engineering applications. The cell study using umbilical cord blood-derived mesenchymal stem cells has confirmed the in vitro biocompatibility and cell supportive property of the scaffold thereby depicting their potentiality for future clinical applications.
Biocompatible Materials ; Chitosan ; Congenital Abnormalities ; Crystallins ; Extracellular Matrix ; Foreign Bodies ; Fourier Analysis ; Fungi ; In Vitro Techniques ; Mesenchymal Stromal Cells ; Methods ; Microscopy, Electron, Scanning ; Nanofibers* ; Polymers ; Tissue Engineering* ; Umbilical Cord ; X-Ray Diffraction