Chorangiosis placenta with 5-vessel umbilical cord with omphalomesenteric duct remnant: An unusual association

[Influence of placental pathological chorangiosis on neonates: an analysis of 450 cases]

OBJECTIVE

To study the influence of placental pathological chorangiosis in the mother on the mortality of neonates and the incidence rate of complications.

METHODS

A retrospective analysis was performed for the neonates who were hospitalized within 3 days after birth in the Department of Neonatology, Xiamen Maternal and Child Health Hospital, from July 2016 to February 2020. According to whether the placental pathology showed chorangiosis, the neonates were divided into an observation group and a control group (n=450 each). The two groups were analyzed in terms of general status, maternal comorbidities during pregnancy, neonatal mortality, and incidence rate of complications in neonates.

RESULTS

Compared with the control group, the observation group had a significantly higher cesarean section rate (P < 0.05) and a significantly higher incidence rate of maternal gestational hypertension (P < 0.05). The observation group had significantly higher incidence rates of congenital malformation, small-for-gestational-age birth, and low Apgar score than the control group (P < 0.05). The observation group also had significantly higher mortality rate and incidence rates of brain injury, retinopathy of prematurity, and extrauterine growth retardation (P < 0.05).

CONCLUSIONS

Neonates born to mothers with placental pathological chorangiosis tend to have a higher morbidity rate and incidence rate of complications. It is important to improve the understanding of chorangiosis and provide intervention as soon as possible, in order to reduce complications and improve prognosis.

Five-vessel umbilical cord and fetal outcome: an obstetric overview

PURPOSE

The birth of a child with an increased number of blood vessels in the umbilical cord (UC) is a rare event and has been previously reported to be associated with a higher incidence of congenital anomalies.

METHODS

A case of a healthy female infant with an intra-uterine growth restriction (IUGR), born from a bicornuate uterus at 37 weeks of gestation and weighing 2500 g with a diagnosis of five-vessel UC made post-natally, on gross examination of the UC and confirmed by histopathological examination is documented. In particular, sections from the UC showed four umbilical arteries (UA) and one umbilical vein (UV). A review of literature was performed.

RESULT

The physical examination of the baby after birth was normal. To the best of our knowledge, this is the first case to document the association of five-vessel UC with IUGR and the Mullerian anomaly of bicornuate uterus.

CONCLUSION

The detection of supernumerary blood vessels in the UC mandates comprehensive workup for associated congenital anomalies but this case suggests that such finding might not always serve as an ominous sign for an adverse perinatal outcome.