Clinical and pathological umbilical cord abnormalities in fetal thrombotic vasculopathy
Clinical and pathological umbilical cord abnormalities in fetal thrombotic vasculopathy
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DOI：
10.1016/j.humpath.2004.08.003
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发表时间：
2004-12-01
期刊：
影响因子：
3.3
通讯作者：
Redline, RW
中科院分区：
文献类型：
--
作者：
Redline, RW
虽然遗传性胎儿凝血功能障碍在偶然情况下可能导致胎儿血栓性血管病(FTV)，但几项研究未能表明这两种疾病之间存在显著的联系。这项研究验证了与慢性脐带梗阻相关的血管淤积可能是一个促成因素的假设。研究人群包括125名神经受损的足月儿，他们是临床疏忽诉讼的焦点。在23例胎盘中发现FTV，其定义为平均每张切片上有15个绒毛，表现为完全缺乏血管或绒毛间质核脱离。临床脐带缠绕(即分娩时胎儿颈部或身体部位的真绳结或脐带环)在胎儿宫外孕患者中更为常见(61%比24%，P=0.0009)。潜在的梗阻性脐带病理异常(边缘/膜性附着，华顿凝胶体减少，最大脐带直径
Although inherited fetal coagulation disorders may lead to fetal thrombotic vasculopathy (FTV) in occasional cases, several studies have failed to show a significant association between these 2 entities. This study tests the hypothesis that vascular stasis related to chronic umbilical cord obstruction might be a contributing factor. The study population consisted of 125 neurologically impaired term infants who were the focus of clinical negligence litigation. FTV, as defined by an average of > 15 villi per slide exhibiting either a complete lack of blood vessels or villous stromal karyorrhexis, was found in the placentas of 23 cases. Clinical umbilical cord entanglement (ie, true knots or cord loops around the neck or body parts at delivery) was significantly more common in cases with FTV (61% vs 24% in cases without FTV; P = 0.0009). Potentially obstructive pathological abnormalities of the umbilical cord (marginal/membranous insertion, decreased Wharton's jelly, maximum cord diameter