Stillbirth Following Normal Ultrasound Findings and Maternal Placental Growth Factor Levels |
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| Institution: | 1. Maternal Fetal Medicine, Sinai Health System, Toronto, ON;2. Department of Pathology, Sinai Health System, Toronto, ON;1. Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB;2. Cross Cancer Institute, Edmonton, AB;3. Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, AB;4. Department of Gynecologic Oncology, Tom Baker Cancer Centre, Calgary, AB;5. Department of Obstetrics and Gynaecology, Maulana Azad Medical College, Delhi, India;6. Cumming School of Medicine, University of Calgary, Calgary, AB;1. Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan;2. Division of Neonatology, Center of Maternal-Fetal Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan;3. Division of Neonatology, Department of Pediatrics, Mount Sinai Hospital and University of Toronto, Toronto, ON;4. Department of Obstetrics & Gynecology, McMaster University, Hamilton, ON;5. Department of Rehabilitation Sciences, McMaster University, Hamilton, ON;6. Division of Neonatology, Department of Pediatrics, Nagano Children''s Hospital, Nagano, Japan;1. Editor-in-chief, JOGC;2. Department of Obstetrics and Gynecology, McGill University, Montréal, QC;1. Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, McMaster University, Hamilton, ON;2. Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON;3. Department of Radiology, McMaster University, Hamilton, ON;4. Department of Obstetrics & Gynecology, McMaster University, Hamilton, ON;5. Canadian Premature Babies Foundation, Toronto, ON;6. Department of Pediatrics, Mount Sinai Hospital and University of Toronto, Toronto, ON;7. Department of Newborn and Developmental Paediatrics, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON;8. Division of Neonatology, Foothills Medical Centre, Calgary, AB;9. Department of Obstetrics and Gynaecology, Mount Sinai Hospital and University of Toronto, Toronto, ON |
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| Abstract: | BackgroundAttempts to reduce the current rate of antepartum stillbirth in the late third trimester have largely focused on the accurate identification of fetal growth restriction. Universal ultrasound significantly increases detection, especially when combined with maternal angiogenic growth factors, but this screening strategy is not well suited to identify umbilical cord pathology. While this poses unique challenges to pregnancy care, the recurrence risk of cord obstruction is low in comparison with many intrinsic placental diseases.CaseA 30-year-old woman with normal uterine artery Doppler waveforms, fetal growth ultrasounds, and circulating placental growth factor experienced an unexpected third-trimester stillbirth. Placental pathology demonstrated fetal vascular malperfusion and cord hyper-coiling.ConclusionDespite normal placental function, the otherwise healthy fetus is at risk of antepartum stillbirth due to cord-related pathology. |
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| Keywords: | umbilical cord |
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