New Venue

12 Nov

I will be transferring some of the material from http://www.pediatricperinatalpathology.com to this WordPress site. I will concentrate on using it for now as a blog on obstetrical pathology rather than an online textbook. I encourage others to participate and start some conversations. I will be commenting on the published literature, on placenta cases, and on perinatal autopsies.

2 Responses to “New Venue”

  1. halitpinar November 21, 2012 at 8:48 am #

    Excellent idea!

  2. Geoff Machin November 29, 2012 at 2:18 pm #

    Nov 26-12 article. Wrt cord compression and stillbirth, you don’t mention the cord coil index in your case (and cord length is presumably not known). I think that the vulnerable vessel in cord compression is the vein, because the contained blood is at negligible pressure and the medial wall is thin. Given that stem villous VENOUS distension is entering into the equation, it seems to me that it is venous compression, not arterial, that is the factor here. Hence I don’t agree with the idea that avascular villi may result from embolism into the parenchyma from chorionic plate vessels, which would have to be arterial. I think abnormal coiling is by far the most common cause of (intrinsic) compression, altho the abnormally coiled cord is clearly also vulnerable to extrinsic compression. And considerations of cord length also apply. See also a new paper in current issue of Placenta on cord diameter. Most over-coiled cords as received in the lab were much more markedly coiled in utero/vivo/mortuo, as evidenced by the deep grooves.
    The next steps in human evolution, if not back to egg-laying, involves the provision of 2 umbilical veins, like in some other species, so there is a fail-safe (having only one umbilical vein is unacceptable); also a small heart in the placenta to jack up the pressure in the umbilical vein and speed that blood back through the foramen ovale and also offer some more protection against cord compression. Geoff Machin

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