title: Absent end diastolic flow in umbilical artery and umbilical cord thrombosis at term of pregnancy.
abstract: BACKGROUND
  Meconium staining of the fetus and placenta is associated with increased neonatal mortality and asphyxia. Very often it is unclear whether the discharge of meconium is a cause or an effect of fetal distress. In the available literature there are no large epidemiological studies of pregnancy outcome with meconium-related lesions, even though this could be useful to improve our state of knowledge on this topic.
  
  
  METHODS
  A case of umbilical cord vascular necrosis is described. A severely asphyxiated infant was delivered at 39 weeks' gestation by cesarean section due to alarming results of fetal heart rate monitoring and rupture of membranes with meconium-stained amniotic fluid. There was no meconium aspiration. We report a review of 15 similar cases. In the whole series, a linkage between umbilical cord vascular necrosis and evidence of remote meconium discharge always seems to be detectable. The pathophysiological mechanism is unknown.
  
  
  CONCLUSIONS
  It is still not clear why only a tiny percentage of cases with meconium-stained amniotic fluid develops umbilical cord lesions and poor pregnancy outcome. Further investigations are needed to explain why some meconium-stained newborns suffer severe neurological and other damage even without meconium aspiration.
authors.affiliation: A. Fa. R. Associazione Fatebenefratelli per la Ricera, Ospedale Fatebenefratelli Isola Tiberina, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Larciprete
authors.forename: Giuseppe
authors.initials: G
authors.lastname: di Pierro
authors.forename: Francesco
authors.initials: F
authors.lastname: Giacomello
authors.forename: Criselda
authors.initials: C
authors.lastname: Santacroce
authors.forename: Herbert
authors.initials: H
authors.lastname: Valensise
authors.forename: Domenico
authors.initials: D
authors.lastname: Arduini
mesh_terms: D000328:Adult; D003971:Diastole; D005260:Female; D005323:Fetal Monitoring; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008470:Meconium; D011247:Pregnancy; D013927:Thrombosis / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D014469:Umbilical Arteries / Q000473:pathology / Q000503:physiopathology; D014471:Umbilical Veins / Q000473:pathology / Q000503:physiopathology