A death of one fetus in twin pregnancy is a rare obstetric complication. And the stenosis of umbilical cord artery is a very rare complication of cord abnormalities. The umbilical cord showed a false knot due to accentuation of a vascular spiral with a dilated vein and two arteries with incomplete patency of the lumen. This is the first report of single demise of twin pregnancy due to umbilical artery stenosis and umbilical vein varix.
Arteries ; Constriction, Pathologic ; Fetus ; Humans ; Pregnancy, Twin ; Twins ; Umbilical Arteries ; Umbilical Cord ; Umbilical Veins ; Veins

The effects of lumbar epidural anesthesia for eleetive Cesarean section with 2% 1idocaine containing 1: 200,000 epinephrine on newborn Apgar scores, maternal vein, umbilica1 vein, and umbilical artery plasma concentration of lidocsine at delivery were studied in 9 parturients. With patients in a sitting position, single epidural anesthesias were performed with a 17 gauge Tuohy needle. 25ml of 2% lidocaine with 1: 200,000 epinephrine was used as a local anesthetic. Maternal venous blood samples for the measurement of plasma concentrations of lidocaine were obtained from an indwelling venous catheter at the time of delivery. In addition, blood was collected from a doubly clamped section of umbilical cord for the measurement of lidocaine plasma levels. Neonates were evaluated by Apgar scores at 1 and 5 min, Apger scores were assigned by the pediatricians. Maternal venous lidocaine concentrations at the time of delivery(mean+/-SD) were 3.00+/-0.45ug /ml, and the ratio between umbilical and maternal venous levels was 0.535+/-0.163. All newborns had Apgar scores of 7 or more at 1 min and 5 min, and the was no significant difference between the 1 min and 5 min Apgar scores. It is concluded that epidural anesthesia using 25ml of 2% lidocaine with 1: 200,000 epinephrine for Cesarean section has no adverse effects on both mothers and neonates.
Anesthesia, Epidural* ; Catheters ; Cesarean Section* ; Epinephrine ; Female ; Humans ; Infant, Newborn ; Lidocaine* ; Mothers ; Needles ; Plasma* ; Pregnancy ; Umbilical Arteries ; Umbilical Cord ; Veins

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

OBJECTIVES: The purpose of this study is to establish animal model of extracorporeal membrane oxygenation (ECMO) system that uses membreane type oxygenator and circulation circuit of umbilical artery and vein. Blood gas and hemodynamic changes in the fetal goat undergoing ECMO were also evaluated. METHODS: Total 15 pregnant goat had been used to perform extrauterine fetal incubation using ECMO through umbilical artery and vein. Cesarean-section was performed to pregnant goat (35 kg) of 120-130 days of gestation to insert catheters (8 Fr) into the umbilical artery and vein. The tip of inserted catheter's the other end was connected with the circuit system including membrane type oxygenator (Polystan) and roller pump. A total of 300 ml of blood was drawn from donor nonpregnant goat and primed into circuit on the day of surgery. The goat fetus was immersed in a chamber filled with artificial amniotic fluid to monitor blood flow dynamics and blood gas was analyzed. RESULTS: The ECMO system using umbilical cord in the extrauterine incubation of fetal goat was developed and maximum survival of goat fetus was 34.5 hrs (mean survival was 856.6+/-688 min). Oxygen tension (PO2) in umbilical artery and vein were 20.53+/-2.54 mmHg, 31.03+/-13.03 mmHg and oxygen saturation (SO2) in umbilical artery and vein were 46.61+/-18.14 mmHg, 71.56+/-15.39 mmHg. Mean blood flow was 176+/-62 ml/min/kg. CONCLUSION: We suggest that our experimental model as an extrauterine fetal research could be a reasonable method in future advanced studies. However, longterm survival of extrauterine fetus needs more suitable hemodynamic and blood gas condition supported by further researches.
Amniotic Fluid ; Catheters ; Extracorporeal Membrane Oxygenation* ; Female ; Fetal Research ; Fetus ; Goats* ; Hemodynamics* ; Humans ; Membranes ; Models, Animal ; Models, Theoretical ; Oxygen ; Oxygenators ; Pregnancy ; Tissue Donors ; Umbilical Arteries* ; Umbilical Cord ; Veins*

An umbilical vein aneurysm is rare, but appears to be associated with fetal morbidity and mortality. There are no specific guidelines for pregnancy with umbilical vein aneurysm and the management is substantially up to the clinician. We report a case of intra-amniotic umbilical vein aneurysm diagnosed at 35 gestational weeks by ultrasound. Because the aneurysm was growing rapidly, prompt cesarean delivery was conducted. After delivery, a huge fusiform umbilical cord was noted, which was confirmed to be umbilical vein aneurysm by pathological examination. We also reviewed previous reported cases and summarized the management strategies of prenatally detected umbilical vein aneurysms. In addition, the umbilical vein in this case report had the largest size ever reported.
Aneurysm* ; Karyotyping ; Mortality ; Pregnancy ; Ultrasonography ; Umbilical Cord ; Umbilical Veins* ; Varicose Veins

Umbilical catheters have been used in NICUs for drawing blood samples, measuring blood pressure, and administering fluid and medications for more than 50 years. When the patient does not need the umbilical catheter or complications associated with umbilical catheters have risen, the catheter must be removed. In this process, the catheter may snap or be cut off and the fragment may migrate to a near vessel or to the heart and cause infection, thrombosis, or arrythmia. We report a case where in the process of removing an umbilical vein catheter, the catheter was stuck to the dried umbilical cord and pulling at it caused the catheter to snap. An immediate roentgenogram showed the fragmented catheter had migrated to the left pulmonary artery. Using an intravascular snare with a femoral approach, we were able to collect the remaining catheter and remove it from the patient's body without any complications.
Arrhythmias, Cardiac ; Blood Pressure ; Catheters* ; Heart ; Humans ; Pulmonary Artery ; SNARE Proteins* ; Thrombosis ; Umbilical Cord ; Umbilical Veins*

BACKGROUND: The problem of psychological complications (trauma) by intraoperative awareness is a well discussed issue recently. The bispectral index (BIS) is reported to be closely related to the sedation and consciousness of anesthetics. This study was to observe the effects of ketamine injection and enflurane inhalation on the BIS, Apgar score of the neonate and blood gas analysis of umbilical cord artery and vein with general anesthesia for a Cesarean section. METHODS: The subjects of the study were 30 pregnant women who received a Cesarean section with general anesthesia. Before the delivery enflurane 1.0% inhalation group (group 1, n = 10), ketamine 20 mg injected group (group 2) and both ketamine 20 mg injected and enflurane 1.0% inhalation group (group 3) were assessed by BIS, blood pressure, heart rate, induction-delivery time, Apgar score of the neonate at 1, 5 minutes and blood gas analysis of the umbilical artery and vein. RESULTS: The BIS of all groups was over 70 after tracheal intubation and the ketamine injected group (group 2) was higher than the enflurane inhalation group (group 1) from 2 minutes after tracheal intubation. The BIS of the both ketamine 20 mg injected and enflurane 1.0% inhalation group (group 3) was lower than the ketamine injected group (group 2), 4 minutes after tracheal intubation. The Apgar score of neonates and blood gas analysis of the umbilical cord artery and vein had no significant differences between these groups. CONCLUSIONS: In the anesthetics injected before delivery in a cesarean section under general anesthetics, a small dose of ketamine can increase the BIS while a small dose of ketamine with 1.0% enflurane inhalation decreases the BIS, but in all groups the BIS was over 70 which can cause intraoperative awareness. Thus to avoid this problem, more studies are needed on the methods of anesthesia and multifactorial approaches to increase the utility of BIS monitoring.
Anesthesia ; Anesthesia, General* ; Anesthetics ; Anesthetics, General ; Apgar Score ; Arteries ; Blood Gas Analysis ; Blood Pressure ; Cesarean Section* ; Consciousness ; Enflurane ; Female ; Heart Rate ; Humans ; Infant, Newborn ; Inhalation ; Intraoperative Awareness ; Intubation ; Ketamine ; Pregnancy ; Pregnant Women ; Umbilical Arteries ; Umbilical Cord ; Veins

OBJECTIVE: The umbilical cord consists of two arteries and one vein and it functions in the transport between the maternal and fetal circulation. Biochemical analysis of fetal cord blood (FCB) during delivery could be beneficial in terms of understanding the fetal environment. In this study, we aimed to investigate oxidative parameters like malondialdehyde (MDA), superoxide dismutase (SOD), and catalase (CAT) levels in FCB during delivery. METHODS: We collected FCB samples during caesarean section. Our study included 33 depressed mothers and 37 healthy controls. We investigated MDA, SOD, and CAT levels in FCB samples. RESULTS: We found no significant difference between groups in terms of MDA (p=0.625), SOD (p=0.940), and CAT (p=0.413) levels. CONCLUSION: Our study reveals probable protective effects of the placenta from oxidative stress. Future studies should include larger samples.
Animals ; Arteries ; Catalase* ; Cats ; Cesarean Section ; Depression ; Female ; Fetal Blood* ; Humans ; Malondialdehyde* ; Mothers* ; Oxidative Stress ; Placenta ; Pregnancy ; Superoxide Dismutase* ; Superoxides* ; Umbilical Cord ; Veins

No abstract available.
Umbilical Cord*

No abstract available.
Umbilical Cord*