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.
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Recent Posts
- A study protocol of stillbirth in need of a PI. March 12, 2023
- A system approach to stillbirth, perinatal brain injury and unexpected deterioration of fetal heart rate tracing. December 12, 2021
- Autopsy revision to the MRI stillbirth proposal February 7, 2021
- Autopsy brain manual and next step January 31, 2021
- New autopsy manual section on liver January 17, 2021
- New autopsy manual page Thyroid January 5, 2021
- New Page: Autopsy Manual: Spleen January 3, 2021
- New Post, Autopsy Manual: Lung December 27, 2020
- New Page of Autopsy Manual: Heart December 20, 2020
- Stillbirth: mechanisms and causes December 9, 2020
- New Page on Pancreas December 5, 2020
- New Page November 29, 2020
- New page on adrenals November 22, 2020
- Chronic Histiocytic Intervillositis: Study Proposal November 15, 2020
- Additions to intervillositis digital book section November 8, 2020
- Proposal for a digital book on placenta pathology November 1, 2020
- New page added, An invitation to study stillbirth October 18, 2020
- Cesarean section association with autism and attention deficit? September 30, 2019
- A new page on Villitis of Unknown Etiology August 27, 2019
- Comments on Spiral Artery June 27, 2019
- An Obstetrical Care Research Center February 8, 2019
- New page on fetal cells October 18, 2018
- TIPPS: The International Placental Pathology Study Group? September 11, 2018
- A Simple Measure: Kick counts (and a plea for measuring the untethered length of the umbilical cord) September 8, 2018
- Umbilical cord accident 2 August 24, 2018
- Just added page on fetal vascular malperfusion August 23, 2018
- Pathology Manual August 19, 2018
- Stillbirth Research Idea August 16, 2018
- Open letter to obstetricians July 18, 2018
Autopsy Manual
- Autopsy Manual: In utero lie and presentation
- Autopsy Manual: Gestational Age
- Autopsy Manual: Duration of postmortem retention
- Autopsy Manual: Measurements and Weights
- Autopsy Manual: Adrenals
- Autopsy Manual: Thymus
- Autopsy Manual: Pancreas
- Autopsy Manual: The Heart
- Autopsy Manual: Lung
- Autopsy Manual: Spleen
- Autopsy Manual: Thyroid
- Autopsy Manual: Liver
- Autopsy Manual: Kidney
- Autopsy Manual: Brain
Obstetrical Pathology Manual
- Chapter 1 Fetal Asphyxia: Section A Introduction and John Little
- Chapter 1 Fetal Asphyxia: Section B Twilight Sleep
- Chapter 1 Fetal Asphyxia: Section C Guinea Pigs
- Chapter 1 Fetal Asphyxia: Section D Primate model
- Chapter 1 Fetal Asphyxia: Section E Dr. Ron Myers
- Chapter 1 Fetal Asphyxia: Section F Ovine model
- Chapter 2: Part 1: Umbilical cord accident
- Chapter 2 Umbilical cord “accident”: Part 2
- Chapter 2 supplement: Short case report #1: Umbilical cord compression?
- Chapter 2 supplement: Short Case Report #2: Umbilical Cord Compression
- Chapter 2 supplement: Short Case Report #3: Umbilical Cord Prolapse
- Chapter 2 supplement: Short case report #4: multiple nuchal cord wrappings
- Chapter 3 Fetal Vascular Malperfusion
- Chapter 4 Decidua: Section A Placenta Accreta
- Chapter 4 Decidua: Section C Breus mole (Subchorionic thrombohematoma), fibrin plaques and subchorionic cysts.
- Chapter 5 Stillbirth & Asphyxia
- Chapter 6 Meconium
- Chapter 7: Fetal blood cells
- Chapter 9 Placental Perfusion: Section A Spiral Arteries
- Chapter 9 Placental Perfusion: Section D Placental Infarction
- Chapter 10 Lesions of Villous Injury: Section A Villitis of Unknown Etiology (VUE) and Chronic Intervillositis
- Chapter 10 Lesions of Villous Injury: Section B Maternal Floor Infarction/ Massive Fibrinoid Infiltration (MFI)
- Chronic histiocytic intervillositis (CHIV)
- Chapter 13 Preterm Labor: Section A The Cervix
- Chapter 13 Preterm Labor: Section B Chorioamnionitis
- Chapter 13 Preterm Labor: Section C Subacute Necrotizing Funisitis (SNF)
Excellent idea!
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