Machin comment on stillborn case posted on New Venue post, see there

30 Nov

Dr. Geoff Machin commented on the stillborn case, but somehow the comment attached to the new venue post. His argument is that cord torsion is very important and the vein is more vulnerable than the arteries to torsion. I don’t disagree. What I do have a problem with is the value of the cord coiling index. I think the pitch of acute torsion is more affected by the length of cord free to twist than any history of torsion embedded in the cord structure. But all of this needs some good experimental work which could be done. I will expand on this for Geoff in another post so that I can see where our differences and similarities really are. I also think that if stasis occurs because of venous occlusion, flow will slow everwhere in the system, and where thrombosis occurs may be more related then to vascular injury from turbulence induced stasis and from tissue hypoxia. Arterial emboli to the placenta can occur, we published a case of fetal aortic thrombus that appeared to be guilty, but it may not be an important mechanism. I really should paint the vessels grossly where it is easy to tell vein from artery, to identify them histologically and get a better handle on all this. More later.  Thanks Geoff for responding, and I hope others will read it and think about it.

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