The Placenta Its Membranes and the Umbilical Cord

Stripping The Fetal Membranes

The human placenta is a highly sophisticated organ of interface between mother and fetus, often referred to as the gate-keeper to the fetus. Careful examination of the placenta, its membranes, and the umbilical cord can prove to be a valuable aid in the diagnosis and treatment of the neonate. Gross examination of the placenta takes five minutes, and more sophisticated examination should be considered when there is poor pregnancy outcome, recognizable malformations or abnormalities, multiple...

Effects of Maternal Medication

Fetal Hydantoin Syndrome

During pregnancy, the average fetus is exposed to four physician-prescribed and five self-prescribed drugs. Every drug administered or taken by a pregnant woman presents the mother with both risks and benefits. The risks include the drug's potential as a teratogen or as a cause of toxicity in the fetus. Most human teratogens affect the embryo during a very narrow period of early development as illustrated by the time 24 to 33 days gestation during which the fetus is susceptible to limb...

Birth Trauma

Vocal Cord Edema Causes

Birth trauma refers to those injuries sustained during labor and delivery. Despite skilled and competent obstetric care, some may be unavoidable. Factors predisposing infants to injury include macrosomia, prematurity, cephalopelvic disproportion, dystocia, prolonged labor, and abnormal presentation. In 1988, birth injuries ranked eight as major causes of neonatal mortality and caused 4.6 deaths per 100,000 live births. The clinician who cares for newborn infants must be familiar with the...

Fetal Qrowth and Assessment of Gestational

Dubowitz Neurological Exam

The normal term infant has completed a gestation of gt 37 weeks and has a birth weight gt 2500 g. Accurate dating of pregnancy is important in evaluating the abnormally grown infant at birth. There are two different populations of low birthweight infants, those who are 1 born premature in gestation i.e, at lt 37 weeks or 2 small for gestational age SGA . Infants are SGA for one of two reasons 1 a normal intrauterine environment but abnormal development due to fetal factors i.e., chromosomal...

Multiple Births

Plethoric Appearance

Multiple gestation occurs frequently in pregnancy. The most common is twinning, which occurs in about one in every 80 pregnancies. There are two types of twins monozygous or identical and dizygous or fraternal. The monozygous twin rate is 1 in every 200 pregnancies. It results from a single ovulation with subsequent splitting of the developing egg within the first 14 days. There is no familial tendency. Dizygous twinning results from double ovulation and fertilization and is probably determined...

Transverse Facial Cleft

Encephalocele

Another example of congenital amputation of the left leg and the toes of the right foot by amniotic bands. In primary limb reduction defects, the skin at the amputation is smooth and there is underlying subcutaneous tissue. In secondary limb reduction deformities, the skin shows ulceration or scarring and has no underlying subcutaneous tissue. Radiography shows the stump of the bone is smooth in primary limb reduction defects and the stump of the bone is jagged in secondary...

Babies Born In The Caul

Subconjunctival Hemorrhage Birth

Fetus born in a caul with a nuchal cord. Cord around the neck once is present in about 20 of deliveries and, in about 2 of deliveries, there is a cord around the neck twice. This common finding generally does not cause problems unless the cord constricts the neck tightly. Klima, T. Figure 4.21. Fetus born in a caul with a nuchal cord. Cord around the neck once is present in about 20 of deliveries and, in about 2 of deliveries, there is a cord around the neck twice. This common...

Caudal Regression Syndrome

Caudal Regression

Frontal view of another infant with arthrogryposis. Extreme intrauterine compression over an extended period of time can produce such severe distortion in multiple joints that supporting ligaments become contracted and opposing tendons stretch. The muscles acting across these joints may atrophy, creating a picture indistinguishable from the intrinsic forms of arthrogryposis multiplex congenita. Figure 5.56. This infant with arthrogryposis demonstrates the severe congenital joint...