Association of omphalocele with a patent urachus presenting as a large umbilical cystic mass in a newborn

Simultaneous presentation of omphalocele, patent urachus, and umbilical cyst is very rare. There is wide range of differential diagnosis for umbilical cyst. Accurate assessment of umbilical cysts is important to evaluate other abnormalities.     

Partial molar pregnancy with a normal live fetus and umbilical cord abnormalities: A novel association with long‐term follow‐up: A case report

A euploid fetus in a partial molar pregnancy can develop umbilical cord abnormalities as pregnancy goes on. So, careful examination of the umbilical cord can determine fetuses at risk for ominous adverse effects.     

胎儿四血管脐带合并一过性腹内段右脐静脉扩张1例

孕妇31岁,孕2产0,体外受精胚胎移植术后受孕.孕10周+2超声显示宫内早孕,双绒双羊双胎,其中1个孕囊胚胎停止发育;胎儿超声检查显示宫内单活胎,颈项透明层(nuchal translucency,NT)厚约1.0 mm.孕22周+4胎儿超声发现脐血管数量异常(脐动脉2条,脐静脉2条,图1A),且右脐静脉入腹壁后局限性...     

Sonographic umbilical vessel morphometry and perinatal outcome of fetuses with a lean umbilical cord

PURPOSE: This study was undertaken to assess whether changes in umbilical cord vessel morphometry are associated with an increased risk of adverse perinatal outcome among fetuses with a lean umbilical cord on sonography. PATIENTS AND METHODS: A total of 160 fetuses with a sonographically lean umbilical cord (cross-sectional area below the 10th percentile for gestational age) after 20 weeks of gestation were enrolled. The cross-sectional areas of the umbilical cord and its vessels were measured. Outcome variables investigated were perinatal death, admission to the neonatal intensive care unit, intrauterine growth restriction, and 5-minute Apgar score. RESULTS: The proportions of perinatal death (1/96 versus 6/64, p < 0.05) and admission to the neonatal intensive care unit (17/96 versus 22/64, p < 0.05) was significantly higher among fetuses with an umbilical vein area below or equal to the 10th percentile for gestational age than among those with an umbilical vein area greater than the 10th percentile. No differences were found in the proportions of perinatal death, neonatal intensive care unit admission, 5-minute Apgar score < 7, and intrauterine growth restriction when fetuses with umbilical vein areas below or equal to the 10th, the 5th, and the 2.5th percentiles for gestational age were compared. No difference was found in the umbilical artery area and Wharton's jelly area among the groups. CONCLUSION: Among fetuses with a sonographically lean umbilical cord, a significant relationship exists between an umbilical vein area below or equal to the 10th percentile and an adverse neonatal outcome.     

Umbilical cord cyst detected in the first trimester by two- and three-dimensional sonography

A case of umbilical cord cyst was identified via 2-dimensional and 3-dimensional sonographic examination at 8 weeks' menstrual age. The cyst was solitary, measuring 18.0 mm, and it was located close to the placental insertion on the umbilical cord. The gestational sac and yolk sac diameters and the fetal heart rate were within normal ranges for menstrual age. Follow-up 3-Dimensional sonographic examination in the second trimester showed complete resolution of the cyst. Amniocentesis revealed a normal karyotype, and a normal infant was delivered at term.     

Prenatal color Doppler sonographic evaluation of nuchal encirclement by the umbilical cord

PURPOSE: The aim of this study was to assess whether Doppler flow velocimetry of the fetal middle cerebral and umbilical arteries is affected by nuchal encirclement by the umbilical cord (nuchal cord) in the prenatal period. PATIENTS AND METHODS: The position of the fetal umbilical cord was assessed on color Doppler sonography in pregnant women who were referred to our radiology department between September 14, 1998, and January 14, 2000. Pulsatility and resistance indices and the ratio of peak systolic blood flow velocity to diastolic velocity of the umbilical arteries and middle cerebral arteries of all fetuses were prospectively obtained with Doppler flow velocimetry. The fetuses were categorized into 2 groups: group 1 consisted of fetuses without sonographic evidence of nuchal cord and group 2 of fetuses with sonographic evidence of nuchal cord. The results were statistically analyzed with independent-groups t test. A p value of less than 0.05 was considered significant. RESULTS: During the study period, 230 pregnant women underwent sonographic examination of the fetus, and 68 fetuses were delivered. The sonographic examinations were performed at 24-41 weeks' menstrual age. Of the 46 fetuses in group 1, 1 fetus had nuchal cord at delivery; of the 22 fetuses in group 2, 4 did not have nuchal cord at delivery. The sensitivity of color Doppler sonography in detecting nuchal cord was 95% (18 of 19 fetuses), the specificity was 92% (45 of 49), the negative predictive value was 98% (45 of 46), and the positive predictive value was 82% (18 of 22). No statistically significant differences in middle cerebral artery or umbilical artery Doppler flow velocimetry values were detected between the 2 groups. CONCLUSIONS: Color Doppler sonography is a sensitive and specific method of diagnosing nuchal cord, but fetal middle cerebral artery and umbilical artery Doppler flow velocimetry values are not affected by the presence of nuchal cord in the prenatal period.     

彩色多普勒超声诊断胎儿脐带绕颈及血流动力学研究

目的探讨脐带绕颈的超声诊断价值及脐动脉血流动力学变化的意义，为临床提供正确的分娩方式。方法选择足月妊娠者产前常规超声检查，并对脐带绕颈者脐动脉阻力指数（RI）及收缩期最大血流速度与舒张末期最大血流速度比值（S／D）进行检测，与60例无脐带绕颈组进行分组比较。结果超声诊断脐带绕颈特异性及准确率分别为97．61％及96．17％。脐动脉RI、S／D值在脐绕颈全组均增高，差异有显著性（P〈0．05）；绕颈1周组RI、S／D值虽增高但差异无显著性；绕颈2、3周组差异均有非常显著性（P〈0．01）。结论超声诊断脐带绕颈有较高的特异性及准确性，脐绕颈时脐动脉RI、S／D值检测对临床分娩方式的选择及降低围产儿不良结局的发生有指导意义。     

Sonographic detection of an infected maternal urachal cyst during pregnancy

Infection of a maternal urachal cyst during pregnancy is rare; Sonography is an important diagnostic tool that can help minimize maternal and fetal complications. We describe the case of a 35‐year‐old multiparous woman presenting in the third trimester with 2 weeks of fever, abdominal pain, and urinary symptoms. Imaging showed a 5‐cm complex anterior midline mass, found intraoperatively to be eroding into the uterus. Sonographic imaging aided in the diagnosis and management of the urachal cyst, and antepartum sonographic measurements of the lower uterine segment helped to counsel regarding a trial of labor. Following treatment, the patient stabilized and had an uncomplicated vaginal delivery.     

产前超声提示脐带羊膜分离1例

孕妇32岁,孕30+2周超声检出脐带与羊膜分离(图1A),孕33+5周分离程度加重、脐动脉内径变窄;孕34+1周无明显诱因出现下腹部阵痛,伴少量淡黄色、清亮、稀薄阴道流液,门诊以"先兆早产、胎膜早破"收治入院.既往孕3产0;无羊膜腔穿刺及脐带血穿刺史,孕期血压正常.     

Prenatally detected umbilical cord tumor as a sign of diffuse neonatal hemangiomatosis

We report a case of a prenatally detected hemangioma of the umbilical cord as an early sign of diffuse neonatal hemangiomatosis (DNH). The newborn was diagnosed with multiple hemangiomas in the liver, intestines, skin, and brain. Prenatal ultrasound findings, neonatal appearance of the hemangiomas, and the associated complications are illustrated. Interdisciplinary investigations as well as operative and systemic treatment approaches proved to be challenging. This case illustrates how prenatal ultrasound with color Doppler facilitates the early diagnosis of DNH and can help through the early referral to specialized centers for appropriate treatment.     

Fetal aneuploidy and umbilical cord thickness measured between 14 and 23 weeks' gestational age.

OBJECTIVE: To evaluate and compare umbilical cord thickness of aneuploid fetuses with umbilical cord diameter nomograms generated from euploid fetuses between 14 and 23 weeks' gestational age. METHODS: A retrospective study was conducted in which 56 fetuses and neonates had diagnoses of abnormal karyotypes, of which 46 fetuses had numerical chromosomal abnormalities. Among these cases, 26 subjects with adequate umbilical cord sonographic images were included in the study. The umbilical cord thickness was measured and plotted against the umbilical cord diameter nomogram that was generated from previously published data. RESULTS: From 26 evaluated fetuses and neonates, in 14 subjects (53.8%), the umbilical cord thickness was greater than the 95th percentile for gestational age. A thick umbilical cord was observed in 57.8% of fetuses with trisomy 21 and 50% of subjects with trisomy 18 and monosomy 45,XO. One fetus with trisomy 2 had umbilical cord thickness within the normal range. The largest number of aneuploid fetuses with thick umbilical cords (87.5%) was observed between 16 and 17 gestational weeks. CONCLUSION: Aneuploid fetuses have thicker umbilical cords than euploid fetuses. The umbilical cord thickness can be related to an increased amount of Wharton jelly. Because of the smaller number of thick umbilical cords in aneuploid subjects at later gestational ages, we speculate that abnormal cord thickness has a natural tendency toward its own resolution with the advancement of gestational age.     

彩超评估脐带旋转指数与脐带异常附着的相关性研究

目的：观察脐带旋转指数异常与脐带附着异常是否相关。方法：超声检测350例孕晚期胎儿的脐带旋转指数（1／A）。该指数为脐动脉围绕脐静脉旋转1个周期后占脐静脉的长度的倒数,指数小于0．1考虑为少旋转。分娩后测量脐带附着点到胎盘边缘的距离,将结果分为正常附着、边缘性附着和帆状附着。结果：少旋转组的胎儿脐带约有76．5％为异常附着,正常旋转或高旋转约有2．2％的脐带异常附着,胎儿脐带旋转指数与脐带附着点到胎盘边缘距离之间的相关系数为r=0．953。结论：脐带少旋转与脐带异常附着有显著相关性,若存在脐带少旋转则可提示存在脐带异常附着。     

人脐血单个核细胞和脐带间充质干细胞移植用于大鼠脊髓损伤的实验研究

目的:探讨人脐血单个核细胞和脐带间充质干细胞(MSCs)移植对脊髓损伤功能恢复的影响,寻找一种更适合治疗脊髓损伤的细胞源。方法:采集新鲜人脐带血和脐带,分离培养单个核细胞和MSCs。将脊髓损伤模型随机分成3组:单个核细胞移植组、MSCs移植组和低糖必需培养基(L-DMEM)培养组。采用免疫组化和免疫荧光检测细胞移植后1—4周细胞在脊髓内的存活情况和迁移情况,使用BBB行为学评分评估大鼠脊髓功能恢复情况。结果:L-DMEM培养液组在术后各时间点观察评分无明显差异,而细胞移植组脊髓功能处于逐渐恢复过程,与L-DMEM培养液比较,差异有显著性意义。单个核细胞移植组对损伤脊髓功能的修复作用较MSCs移植组显著,且差异有显著性意义。结论:与MSCs相比较,人脐血单个核细胞更适合作为治疗脊髓损伤的细胞源。     

脐带采集液中添加美罗培南对脐带间充质干细胞生物学特性的影响

背景：为避免脐带采集过程中发生细菌污染,常在脐带采集液中加入抗生素,实验旨在探索可以抑制污染同时又不会对细胞生长增殖造成影响的新型抗生素。目的：观察美罗培南抗生素对脐带间充质干细胞增殖和分化潜能的影响。方法：实验分2组,使用传统添加青霉素链霉素（终浓度均为100 U/mL）的脐带采集液采集的标本为对照组,使用添加美罗培南（终质量浓度为1.0 mg/L）的脐带采集液采集的标本为实验组,分别采集脐带标本100份,统计两组标本采集液的阳性率。两组脐带分离培养后取第3代细胞绘制生长曲线,流式细胞术分析其表型以及检测成骨、成脂分化能力。结果与结论：经统计,实验组的采集液污染率为3%（3/100）,对照组的采集液污染率为20%（20/100）,可见含有美罗培南的采集液标本污染率明显降低。使用含有美罗培南的采集液采集脐带,经培养后获得的第3代脐带间充质干细胞形态、分化能力以及细胞表型均正常,且细胞增殖能力与对照组相比无差异,因此该抗生素可用于脐带采集液。     

脐带绕颈胎儿脐动脉及大脑中动脉超声血流参数的特点及与胎儿宫内窘迫的相关性分析

目的 探讨脐带绕颈胎儿脐动脉(UA)及大脑中动脉(MCA)超声血流参数的特点及与胎儿宫内窘迫的相关性.方法 将106例胎儿脐带绕颈孕妇、100例正常孕妇分别纳入脐带绕颈组、非脐带绕颈组.根据不同孕周、是否发生胎儿宫内窘迫对脐带绕颈组孕妇进行再次分组,分别为28～36周组(52例)、≥37周组(54例);宫内窘迫组(28...     

胎儿脐带绕颈的MRI、彩超及分娩结果的对照研究

目的:探讨磁共振成像(MRI)及彩色多普勒血流显像(CDFI)对脐带绕颈诊断价值。材料和方法:对48例中、晚期孕妇进行磁共振成像及彩超对照,并和分娩时胎儿的脐带状况作对照分析。结果:48例胎儿出生时,14例脐带绕颈被发现。其CDFI表现均为胎儿颈部红蓝相间的螺旋状脐血管;产前彩超诊为脐带绕颈者14例,其正确诊断率为92.8%,假阳性率7.1%,漏诊率7.1%。脐带绕颈的典型MRI表现为T1和T2加权图像上,呈类圆形或“品”字形低信号结节。产前MRI诊为脐带绕颈者13例,其正确诊断率为85.7%,假阳性率7.1%,漏诊率14.2%。结论:彩超及磁共振成像能较好地揭示胎儿脐带绕颈。     

人脐带间充质干细胞超微结构观察

本研究观察脐带间充质干细胞的超微结构。用胶原酶消化法分离培养足月新生儿的人脐带间充质干细胞(hUCMSC),进行传代培养、扩增,在显微镜下观察其细胞形态。对培养至第3代的hUCMSC进行免疫表型测定,进行成脂细胞、成骨细胞和成软骨细胞诱导分化实验,并在透射电子显微镜、扫描电子显微镜下进行超微结构的观察。结果表明,hUCMSC外观呈梭形和多角形,并可见细胞核;高表达表面标志CD44,CD73,CD105,不表达CD34,CD45,CD31和HLA-DR;能够进行成脂、成骨、成软骨分化。在扫描电子显微镜下可见细胞表面有短而粗的微绒毛突起,在透射电子显微镜下可见到两种不同的细胞形态:一种处于静止期,细胞核大,圆或卵圆形,仅有1个核仁,胞质内细胞器少;另一种处于相对活跃期,同一个细胞内可以看到1个或2个细胞核,细胞器数量丰富、结构清晰,并可见扩张的线粒体。结论:从脐带中分离培养的细胞具有间充质干细胞的生物学特性,具有两种不同状态的超微结构。     

脐血造血干细胞移植中脐血输注的护理

脐血造血干细胞移植中如何使脐血造血干细胞顺利输注人病人体内是移植成功的重要环节,因此,脐血输注的护理尤为重要。笔阐述9例脐血造血干细胞移植患,脐血输注前输注时的护理,脐血输注后并发症的观察及护理3个部分的护理经验。9例患均成功进行了脐血输注。     

人脐带和骨髓源间充质干细胞对脐血单个核细胞增殖能力的影响

目的：探讨人脐带间充质干细胞（UCMSCs）与骨髓间充质干细胞（BMMSCs）在体外对造血干细胞的支持作用。方法分别从人脐带和骨髓中分离、培养间充质干细胞,通过免疫细胞化学染色等方法对其进行表型鉴定;采用流式细胞仪测定脐血单个核细胞的周期分布,采用甲基纤维素法测定脐血单个核细胞混合集落形成单位（CFU-Mix）,比较 UCMSCs和BMMSCs对脐血单个核细胞细胞周期、CFU-Mix形成能力的影响。结果成功培养获得 UCMSCs和BMMSCs,鉴定结果符合预期;与非共培养组细胞相比,UCMSCs和 BMMSCs共培养均能促进脐血单个核细胞进入增殖周期,并增加其形成CFU-Mix的能力（P＜0．05）,但UCMSCs和BMMSCs共培养组之间比较差异无统计学意义（P＞0．05）。结论成功从人脐带和骨髓组织中培养获得间充质干细胞,两种来源的间充质干细胞均能提高脐血单个核细胞的体外增殖能力及 CFU-Mix形成能力,均具有造血支持作用。