Is unexplained third trimester intrauterine death of fetuses with gastroschisis caused by umbilical cord compression due to acute extra-abdominal bowel dilatation? |
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| Authors: | Karim D Kalache Anke Bierlich Hannes Hammer Rainer Bollmann |
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| Institution: | 1. Fetal Medicine Unit, Department of Obstetrics and Gynecology, Campus Charité Mitte, University Hospital - Medical Faculty of the Humboldt-University, Berlin, Germany;2. Clinic of Neonatology, Campus Charité Mitte, University Hospital - Medical Faculty of the Humboldt-University, Berlin, Germany |
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| Abstract: | We report on a case of gastroschisis in which sudden dilatation of extra-abdominal bowel at 34+1 weeks was followed by an unusual umbilical flow velocity waveform (diastolic notching). The condition was associated with normal umbilical Doppler indices, brain sparing effect and a non-reactive cardiotocograph (CTG). Findings at postnatal surgery strongly suggested severe cord compression by the herniated dilated bowel. The significance of notching in the umbilical artery waveform is discussed, as is the potential importance of this sign in the prepartum management of fetuses with gastroschisis. Copyright © 2002 John Wiley & Sons, Ltd. |
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| Keywords: | gastroschisis prenatal diagnosis Doppler ultrasonography |
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