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background: Poor cord care practices contribute to neonatal morbidity and mortality resulting from neonatal infections including tetanus. Identification of negative practices should ultimately improve care and neonatal outcome. Objective: To evaluate cord care practices among mothers attending the Well Baby/Immunization Clinic of the University of Benin Teaching Hospital (UBTH), Benin City. Subjects and Methods: Four hundred and ninety-seven mothers who brought their babies to Well Baby/Immunization Clinic in UBTH between July and August 2009 were interviewed. A structured, pretested questionnaire was used as test instrument to investigate the care of the umbilical cord of their infants in their last deliveries. Results: Harmful or non-beneficial cord care practices were common (79.5%) among mothers in Benin City. Most delivery units used thread (65.6%) and plastic cord clamp (22.7%) to secure haemostasis at the umbilical stump. Other materials used include suture materials, strips of cloth, bandage, plaster and rubber band. Majority of the mothers practiced hand washing before (86.9%) and after (89.3%) cord care. The traditional practices of cord care in Benin City include the use of hot compress (46.1%), menthol-containing balm, herbs, native chalk, petroleum jelly, palm oil, toothpaste (Close-up ), salt, sand and saliva. The most common single agent for cord treatment was alcohol (methylated spirit). \ Conclusion: The attendant risks associated with harmful cord care practices remain real in our communities. There is need for education of the public, using the mass media and health talks in health facilities, to discourage harmful cord care practices while reinforcing beneficial ones.

Background: The interval between delivery and umbilical cord separation varies worldwide. Some maternal, foetal and perinatal factors including cord care practices are known to affect this interval. Objectives: To establish the mean umbilical cord separation time and the effect of maternal and infant characteristics, perinatal factors and cord care practices on this time among healthy babies in northern Nigeria. Methods: An interviewer questionnaire was administered on mothers of healthy babies at Child Welfare Clinics of a tertiary and secondary level hospital in Kano. In each case, information was obtained about mother's parity, place of antenatal care and delivery, gestational age, birth weight, time of umbilical cord separation after birth and cord treatment practices. Results: Five hundred and seventy seven (96.2 percent) of 600 mothers interviewed, took part in the study, four of these mothers had twin gestation. Responses showed that cord separation time ranged from 2 -14 days (4.20 1.70)Three hundred and forty nine (60.9. p e r c e n t ) mo t h e r s a p p l i e d methylated spirit, 145 (25.3 percent) used hot compress, while 50 (8.7 percent) applied toothpaste on the cord. Twenty (3.5 percent) others applied herbs, while nine (1.6 percent) applied dusting powder to the umbilical stump. Cord separation time wa s significantly shorter among babies whose mothers were of high parity, unbooked, and of low educational status. In addition, the use of razor blade, thread, hot compress or application of herbal preparations or toothpaste significantly shortened the separation time (P

Introduction: Single Umbilical Artery (SUA) is a congenital anomaly that can occur either as an isolated finding or in association with other systemic anomalies. Several studies have reported that SUA is linked to dysplastic kidneys, ventricular septal defects, oesophageal atresia, spina bifida, diaphragmatic hernia and cystic hygromas. Therefore, investigating cases of SUA in autopsies is crucial. Aim: To estimate the frequency of SUA in foetal autopsies and determine the association between SUA and other systemic anomalies. Materials and Methods: The present ambispective observational study was conducted in the Department of Pathology, Shri Dharmasthala Manjunatheshwara College of Medical Sciences and Hospital, Dharwad, Karnataka, India, over a 13 year period from January 2009 to December 2021. A total of 63 cases of SUA detected during foetal autopsies were included. Factors such as age, parity and multiple births were collected where available. The hospital-based frequency of SUA was calculated as a percentage. The association between SUA and systemic anomalies was assessed using the Chi-square test. Results: A total of 1338 perinatal autopsies were performed during the study period, with SUA present in 63 (4.70%) cases. The most common associated anomaly was genitourinary defects identified in 16 (25.39%) cases. However, a statistically significant association was observed with musculoskeletal (11.11%), nervous (11.11%), and gastrointestinal system anomalies (19.04%) with a p-value of

Background: Anastomotic leak (AL) is one of the most feared complications following intestinal surgery and is associated with increased complications, costs, length of hospital stay, and mortality. While many pre-clinical animal model studies have successfully demonstrated the efficacy of amniotic membrane (AM) in preventing AL, its clinical utility is less reported. Methods: A single-center, retrospective study was performed on patients who underwent intestinal surgery followed by end-to-end or side-by-side single layer anastomosis and placement of cryopreserved, ultra-thick AM. Post-operative outcomes were assessed including time to first defecation, length of hospital stay, and complications, including incidence of AL. Results: Eleven consecutive patients (7 male, 4 female) underwent open (n = 2) or laparoscopic (n = 9) resection of the sigmoid (n = 6), cecum (n = 2), ascending colon (n = 1), rectum (n = 1), and small bowel (n = 1). Surgery was uneventful in all cases. The time to first defecation was 3.5 ± 2.1 days. After an average follow up of 65.3 ± 42.0 days, none of the patients suffered an AL nor required another colorectal procedure. Conclusion: These preliminary findings suggest the use of cryopreserved, ultra-thick AM following intestinal surgery is safe and may be beneficial in reducing the incidence of AL and post-operative complications. Larger prospective, randomized trials are warranted.

Background and objective: There are no local investigation on the role of the abnormal umbilical cord on neonatal and maternal outcomes in this region. This study aimed to examine the association of umbilical cord abnormalities on neonatal and maternal outcomes in Iraqi Kurdistan. Methods: This is a cross-sectional study, the patients who attended the Duhok Obstetrics and Gynecology Teaching Hospital in Duhok city were examined between 1/11/2020 and 1/11/2021. The sample size is 500 women, inclusion criteria are age>18 years, acceptance to participate, gestational age >24 weeks and singleton pregnancy. The exclusion criteria are women who refused to participate, multiple pregnancy and stillbirth. Results: The mean age of the pregnant women was 29.0 (16 - 45 years old). The most prevalent maternal complications were placenta Previa (7.06%), Polyhydramnios (9.88%), and post-partum hemorrhage (7.06%). In this study the most common abnormalities of UC were abnormal diameter of UC (29.4%), decreased Wharton jelly content (15.5%) and short UC (11.9%).Most of the patients’ babies had normal weight (79.64%), (16.94%) had low birth weight and (3.43%) had very low birth weight. A percentage of the babies died either early neonatal (1.41%) or stillbirth (5.24%). The study found that the patients with abnormal diameter of UC cord were more likely to have babies with low birth weight (35.62% vs. 9.14%, P

Key Clinical Message This case highlights the complex interplay of mental health, stigma, and lack of contraceptive access underlying tragic instances of infanticide. Comprehensive medicolegal investigation paired with cross‐sector efforts to expand reproductive services and transform cultural attitudes is crucial to protect vulnerable women and children.

Introduction: Respiratory distress syndrome (RDS) is the most common cause of respiratory distress, morbidity, and mortality associated with premature delivery. Prolactin is present in very high concentrations in amniotic fluid, and prolactin receptors are present in lung preparations. Prolactin acts as a direct trigger of lecithin synthesis or in a “chain reaction” along the hypothalamic–pituitary–adrenal axis. Thus, prolactin seems to have a role in lung maturation along with many other factors through a complex mechanism. Aim: The aim of this study was to evaluate and compare the umbilical cord serum prolactin levels of preterm infants with and without RDS. Materials and Methods: This was a hospital-based comparative observational study carried out at neonatal units of the department of pediatric medicine in a tertiary care center from April 2019 to May 2020. Out of a total of 80 preterm infants, 40 developed RDS and other 40 served as controls. Umbilical cord blood prolactin levels in neonates were measured in both groups and compared. Chi-square test and an unpaired Student's t-test were used for statistical analysis. Probability was considered significant if

Background and Objective: Sepsis is the third most common cause of death, and the umbilical cord is a significant source of sepsis in the first month of life. This study aimed to compare the effect of Eau de Dalibour and distilled water on umbilical cord separation time and infection in neonates at Kowsar Hospital of Qazvin University of Medical Sciences. Methods: This clinical trial was conducted on 76 infants in two groups of 38 people, using Eau de Dalibour and distilled water as a placebo. In the Eau de Dalibour group, 2-3 ml of the drug was used on the umbilical stump from 3 hours after birth and once every 12 hours until 2 days after the separation of the umbilical cord. In the distilled water group, the same procedure was done with distilled water. Finally, the time of separation of the umbilical cord and signs of infection in both groups were investigated and compared. Findings: There were no significant differences between the two groups in terms of gestational age, sex, or birth weight. Umbilical cord separation time was significantly shorter in the Eau de Dalibour group than in the placebo group (5.1±2.4 and 7.44±2.3 days respectively; p

Key Clinical Message There is a high association between umbilical cord hemangiomas or cysts with fetal mortality. However, favorable outcome is possible with proper prenatal monitoring and care Abstract Umbilical cord hemangiomas are rare neoplasms of vascular origin, commonly found in the free section of the umbilical cord proximal to placental insertion. They are associated with an increased risk of fetal mortality. We present a rare co‐occurrence of an umbilical cord hemangioma and a pseudocyst managed conservatively, with favorable fetal outcome despite the interval increase in size, decreased caliber of the umbilical arteries, and fetal chest compression.

Objective To compare the secretion of cytokines from human umbilical cord-derived mesenchymal stem cells （UC-MSCs） and placenta-derived mesenchymal stem cells （P-MSCs）. Methods UC-MSCs and P-MSCs were isolated and cultured. Cell surface antigens of MSCs were measured using flow cytometry. The adipogenic and osteogenic differentiation capability was analyzed by Oil red O, Von Kossa staining and Alizarin red S staining. The conditioned medium was collected and the expression of cytokines was detected by microarray. Microarray assay results were validated by ELISA and RT-PCR. Results UC-MSCs and P-MSCs had similar surface markers,adipogenic and osteogenic differentiation capacity. Both UC-MSCs and P-MSCs highly expressed insulin-like growth factor-binding protein （IGFBP）-3, IGFBP-4 and IGFBP-6, tissue inhibitor of metallo proteinase （TIMP）-1 and TIMP-2, IL-6, TGF-β1, hepatocyte growth factor, monocyte chemoattractant protein-1 and human intercellular adhesion molecule-1, whereas lowly expressed epidermal growth factor, IL-17, IL-12p40,B lymphocyte chemoattractant, tumor necrosis factor-β （TNF-β）, IL-13, MIP-1δ, Eotaxin-2, IL-12p70 and platelet-derived growth factor-BB. Compared with UC-MSCs,P-MSCscontained five differentially-expressed proteins including TNF receptorⅡ, stem cell factor, nerve growth factor receptor, TGF-β3 and IL-1β. The results of ELISA and RT-PCR were consistent with themicroarray protein data. Conclusion UC-MSCs and P-MSCs have similar surface markers, osteogenic and adipogenic differentiation capacity and cytokine profile.

Freeze-Dried Bovine Bone Scaffold (FDBB) and Decellularized Freeze-Dried Bovine Bone (DCFDBB) are promising new alternative of xenograft material in bone tissue engineering. However, their biocompatibility is still unknown. To investigate whether FDBB and DC-FDBB scaffolds are biocompatible, able to induce cell proliferation attachment in vitro. Human umbilical cord mesenchymal stem cells (hUC-MSCs) culture was exposed to FDBB, DC-FDBB, Deproteinized Bovine Bone Matrix (DBBM) scaffold (as positive control) conditioned medium for 24, 48 and 72 hours (n=8). MTT assay was then performed to measure the number of viable cells at each observation time. Normality (Shapiro-Wilk) and homogeneity (Levene) test were done on the results of the MTT assay, then ANOVA test was performed. To support the finding, further SEM observation was performed. hUC-MSCs were seeded on the surface of each scaffold type (n=3) and incubated for 24, 48 and 72 hours, then SEM observation was done on the scaffold surface to analyse their surface cell attachment. The mean percentage of living cells in FDBB group was the highest among all groups. There were significant differences (p<0.05) in each treatment group at each observation time, except between FDBB and DC-FDBB (48 hours), DC-FDBB and DBBM (48 hours), FDBB and DC-FDBB (72 hours) (p>0.05). SEM examination showed the same results, as the highest number of cell colonization was found on FDBB group at each observation time. FDBB and DC-FDBB scaffolds have good biocompatibility characteristics that can be used as a bone substitute in bone tissue engineering. [ABSTRACT FROM AUTHOR]

Abstract Background Twin reversed arterial perfusion sequence is a rare complication of monochorionic multifetal pregnancies. In this syndrome, the acardiac twin has a nonfunctional heart, while the other twin, the pump twin, has normal development. The pump twin perfuses the acardiac twin and is therefore at risk for cardiac decompensation. In monoamniotic cases, the normal co-twin is also at risk of sudden death due to cord entanglement. Treatment consists of coagulation and transection of the acardiac’s umbilical cord. We report the first intrauterine use in pregnancy of a Ho:yttrium aluminum garnet laser to safely and successfully transect the umbilical cord after Nd:yttrium aluminum garnet coagulation. Case presentation A 30-year-old Caucasian woman was referred to our fetal–maternal medicine unit at 9 weeks gestation with a monochorionic–monoamniotic twin pregnancy complicated by an acardiac twin. After counseling, she opted for an elective intervention to minimize the risks to the pump twin. At 16 weeks, fetoscopy was performed using a single 2-mm entry port. Through this port, a 1.0-mm fetoscope and a 0.365-mm laser fiber were introduced. Under fetoscopic sight and ultrasound (Doppler) guidance, the umbilical cord of the acardiac twin was first coagulated by laser energy using a Nd:yttrium aluminum garnet laser and then, using the same fiber, transected using a Ho:yttrium aluminum garnet laser. The patient underwent cesarean section at 38 weeks and delivered a healthy baby. Conclusions We present the first report on intrauterine use of an Ho:yttrium aluminum garnet laser in human pregnancy. Ho:yttrium aluminum garnet laser energy can be successfully and safely used for umbilical cord transection and carries fewer risks than other methods of transection.

Cord insertion during pregnancy may take and arise different series of characteristics. Intrapartum fetal assessment depends in a significant matter on the umbilical cord, amniotic fluid and placenta. It is also obvious that the umbilical cord may cause problems that can influence labor and pregnancy altogether. There are many concerns about umbilical cord pathology in the past few years, now more than ever because of high morbidity and mortality in both mother and fetus. This high rate of such concern is because of the fetal hypoxia, neonatal asphyxia and hypoxic-ischemic injury at birth. Modern approach and justified interventions are skills required by any young obstetrician and physician who works in Ob-gyn field. The faster the diagnostic and the proper care are embedded, the quicker and better the outcome of the newborn will be, under the circumstances. Multiple gestation involve some risks and they need to be recognized; preterm birth, growth restriction, fetal demise and perinatal mortality nowadays are associated with unfavorable results and traumatized or touching events. The labor and delivery anomalies which might occur is the only clear objective about studying the umbilical cord pathologies and make sure of improving the perinatal outcomes.

Objective: The twisting of the umbilical cord around the fetal neck is a common phenomenon in the delivery room, and despite the lack of univocal evidence of its negative impact on perinatal events, it causes anxiety and stress in patients. The aim of the study was to assess the prevalence of nuchal cord and its impact on adverse obstetric and neonatal outcomes. Methods: We conducted a retrospective cohort study. All patients who gave birth in the clinic within one year (n = 1467) were included in the study group. We compared the prevalence of nuchal cord in distinct subgroups of patients. In the next stage, we estimated the chance of specific perinatal outcomes and compared the neonatal outcomes between groups with and without nuchal cord. Results: Nuchal cord was present in 24% of labors. It was twice as common among patients giving birth vaginally (32.14%) than among patients giving birth by a caesarean section (16.78%, p < 0.001). Nuchal cord was also more frequent in births with meconium-stained amniotic fluid (33.88% vs. 23.34%, p = 0.009). In the group of patients with nuchal cord, we observed a slight increase in the risk of a non-reassuring fetal heart rate trace (OR = 1.55, CI 95% 1.02–2.36) as an indication of the completion of labor by caesarean delivery. We did not note an increase in the risk of completing natural childbirth by vacuum extraction. In the group of nuchal cord patients, there was a higher chance of a serious or moderate neonatal condition in the first minute of life (Apgar 0–7 points) (OR = 2.00, 95% CI = 1.14–3.49). Conclusions: Nuchal cord increases the risk of a caesarean delivery due to a non-reassuring fetal heart rate trace. Nuchal cord increases the chance of a reduced Apgar score (0–7 points) in the first minute of life. The observed relationships do not translate to neonatal arterial blood gas testing.

Background: The literature provides limited evidence of cord blood leptin levels in gestational diabetes mellitus (GDM), with contradictory and inconsistent results with respect to their possible implications for maternal, perinatal, and future complications. Methods: MEDLINE/PubMed, Embase, Scopus, and Web of Science databases were searched in order to investigate the state of evidence on the association of leptin profile in cord blood during perinatal complications in GDM. We critically assessed the risk of bias using the Newcastle-Ottawa scale. Meta-analyses were performed, and heterogeneity and publication bias were analyzed. Results: sixteen primary-level studies were included, recruiting 573 GDM and 1118 control pregnant women. Cord blood leptin levels were significantly higher in GDM participants compared to controls (standardized mean difference [SMD] = 0.59, 95% confidence intervals (CI) = 0.37 to 0.80, p < 0.001). All subgroups also maintained significant differences stratified by continents (Asia: SMD = 0.91, 95% CI = 0.45 to 1.37, p < 0.001; Europe: SMD = 0.38, 95% CI = 0.20 to 0.56, p < 0.001), analysis technique (ELISA: SMD = 0.70, 95% CI = 0.44 to 0.97, p < 0.001; RIA: SMD = 0.30, 95% CI = 0.11 to 0.49, p = 0.002), and sample source (plasma: SMD = 0.71, 95% CI = 0.33 to 1.09, p < 0.001; serum: SMD = 0.55, 95% CI = 0.34 to 0.77, p < 0.001). Conclusion: Cord blood leptin levels were significantly higher in GDM compared to controls. Further research is needed to clarify its role as a predictive biomarker of subsequent metabolic diseases in mothers with GDM and offspring.

Objectives:Vitamin D deficiency and insufficiency in pregnancy can lead to gestational diabetes, preeclampsia, and eclampsia, as well as newborns having Vitamin D deficiency. This study was performed to determine the amount of maternal, neonatal Vitamin D, and consequences of Vitamin D deficiency on birth outcomes. Methods: Hospital-based prospective research was conducted on 528 participants which included 264 mothers and 264 neonates. Pre-delivery maternal venous blood and neonatal cord blood samples were collected and total 25(OH)D concentration was measured. After checking the normality of data distribution, methods of result presentation and statistical analyses were applied. Results: The average level of 25(OH) D in the mother’s blood was 16.53 ± 6.5 ng/ml. The total Vitamin D deficiency in mothers was 191 (72.3%), insufficiency was 63 (23.9%), and 10 (3.8%) registered levels of sufficiency. Maternal serum 25(OH)D was significantly correlated with cord blood 25(OH)D (r = 0.87, p < 0.01). Conclusion: A high proportion of Vitamin D deficiency was found in both mothers and newborns in our study. There is a strong correlation between the amount of Vitamin D in the mother’s blood and in the umbilical cord blood of the newborn. Complications of pregnancy are not associated with Vitamin D status in mother’s blood.

Bone grafts in prosthodontics is required, particularly for socket preservation during denture fabrication. The hydroxyapatite-tricalcium phosphate (HA-TCP) scaffold is one of the materials that may be utilized to preserve sockets because it is employed as a bone regeneration substitute material. This scaffold has the features of being biocompatible, degradable, and non-toxic. To achieve biocompatibility, the scaffold must be readily linked to cells containing growth factors. Human Umbilical Cord Mesenchymal Stem Cells were used to seed the scaffold (HUCMSCs). In bone defect instances, a combination of HA-TCP scaffold material and hUCMSCs is likely to be used as bone remodeling treatment for socket preservation. Objective: this study aimed to investigate the attachment of hUCMSCs in the HA-TCP scaffold using a confocal microscope. The scaffold HA-TCP samples were separated into four groups, and the control group was divided into two, namely HA-TCP 24 hours and HA-TCP 72 hours. The treatment group's sample was separated into two seeding times, 24 hours (P1) and 72 hours (P2) (P2). The sample was subsequently treated with bromodeoxyuridine (BrDU), and the quantity of hUCMSCs attachment was measured using a 400x magnification confocal lightning scanning microscope (CLSM). The Man-Whitney test was used with Kruskal-Wallis analysis to determine the difference between groups (p<0.05). After seeding for 24 hours, hUCMSCS may be attached to the HA-TCP scaffold with a significant difference between the groups. There is a substantial difference between the treatment and control groups, with 24 hours being the optimal shedding period. [ABSTRACT FROM AUTHOR]

Objective:Data on the umbilical cord and postnatal physiological limits of the high sensitivity cardiac troponin T (hs cTnT) in newborns are scarce. This study aims to determine the normal values and upper limits of hs cTnT in healthy newborns. In addition, its clinical significance and usability in neonatal respiratory failure were analyzed.Method:In this non-invasive and retrospective, cross-sectional study, 113 healthy newborns and 93 newborns with non-cardiac respiratory failure, born between July 2018 and January 2020, were evaluated. Hs cTnT was measured in the umbilical cord and 24-96 h after birth in infants.Results:In the healthy group, the median umbilical cord hs cTnT was 38 (17-156) ng/L and 99th percentile hs cTnT was 122 ng/L, and in the respiratory failure group, the median umbilical cord hs cTnT was 72 (27-326) ng/L. Postnatal day 2-4 median hs cTnT was 75 (10-194) ng/L and 99th percentile value was 194 ng/L in the healthy group, and the median hs cTnT was 145 (41-409) ng/L in the respiratory failure group. The calculated area under the ROC curve for umbilical cord hs cTnT was 0.848 [cut-off: 64, 95% confidence interval (CI): 0.79-0.90, sensitivity: 62.4%, specificity: 93.7%], suggesting that umbilical cord hs cTnT is a sensitive marker for the prediction of neonatal respiratory failure. The calculated area under the ROC curve for control hs cTnT was 0.851 (cut-off: 121.5, 95% CI: 0.79-0.90, sensitivity: 71%, specificity: 86.8%), suggesting that control hs cTnT is a sensitive marker for the prediction of neonatal respiratory failure.Conclusion:The results show that the reference range of umbilical cord and postnatal hs cTnT in healthy newborns is higher than that in adults. Both hs cTnT values were higher in the neonatal respiratory failure group than those in the healthy group.

Aim:Preeclampsia is a pregnancy-specific disease of unknown etiology. This study was planned to determine the place of asymmetric dimethylarginine (N, N-dimethylarginine, ADMA) and endothelial cell specific molecule-1 (ESM1, endocan) levels in etiology. The aim of this study was to determine ADMA and endocan levels in maternal and fetal umbilical cord serum of patients with preeclampsia and to evaluate them with clinical data.Methods:This case-control study was conducted between June and December 2020. The clinical and demographic characteristics of the participants were evaluated in the department of obstetrics and gynecology. Thirty-tree women with preeclampsia and 55 healthy women in the same age group were included in our study. Serum ADMA and endocan values were determined by the ELISA method.Results:Maternal and umbilical cord ADMA levels in the preeclampsia group were statistically significantly higher than the control group (p=0.001, p=0.001, respectively). Likewise, the levels of the umbilical cord and maternal serum endocan were statistically significantly higher in the preeclampsia group compared to the control group (p=0.001, p=0.037, respectively).Conclusion:We found that ADMA and endocan molecules associated with endothelial dysfunction in the pathogenesis of preeclampsia significantly increased in maternal and umbilical cord serum.

Objective: The past decade has witnessed a rapid growth in harnessing the potential of adult stem cells for regenerative medicine. An investigational new drug (IND) or a regenerative medicine advanced therapy (RMAT) product must fulfil many requirements, such as stability studies, after cryopreservation. Such studies are important to ascertain the utility of off-the-shelf allogeneic cells for clinical applications. The present work describes a complete characterisation of xenofree human Wharton’s Jelly mesenchymal stromal cells (hWJ-MSCs) before and up to 28 months post-cryopreservation. Materials and Methods: In this experimental study, culture methods that involved plasma derived human serum and recombinant trypsin were used to develop clinical grade cells. Complete cell characterisation involved flow cytometry studies for viability, positive and negative markers, colony forming unit (CFU) potential, population doubling time (PDT), soft agar assay to evaluate in vitro tumourigenicity, karyotype analysis and differentiation studies which were performed before and at 6, 12, 18 and 28 months post-cryopreservation. Results: Our data showed consistency in the flow cytometry, CFU assay, PDT, soft agar assay, karyotyping and differentiation studies. Conclusion: Using our protocols for extended xeno-free culture and cryopreservation of hWJ-MSCs, we could establish the shelf life of the cell-based product for up to 28 months.

Abstract Background Neuritis of the infrapatellar branch of the saphenous nerve can result from iatrogenic injury, entrapment, bursitis, or patellar dislocation. Currently, there is an unmet clinical need for treating refractory neuritis nonsurgically. Case presentation Three patients presented with persistent anterior knee pain caused by neuritis of the infrapatellar branch of the saphenous nerve that had got excellent but only temporary relief from steroid and local anesthetic nerve block. The neuropathic pain diagnostic Douleur Neuropathique 4 questionnaire and painDETECT questionnaire confirmed presence of neuropathic pain. After injection with 25 mg amniotic and umbilical cord particulate, the patient’s pain decreased from 7.3 before injection to 0.3 at 6 weeks postinjection. In addition, neuropathic symptoms significantly improved at 2 weeks and were not present by 6 weeks. By 63 weeks, two of the patients reported continued complete pain relief, while one patient underwent total knee replacement due to an allergy of a previously implanted unicondylar implant. Conclusions This case series suggests that amniotic and umbilical cord particulate may be a viable alternative to reduce pain in patients with neuropathic pain.

Many cultures have developed traditional practices around the management of the umbilical cord stump in the newborn. Treatment with hot water compress or fomentation is well-documented in sub-Saharan Africa but can result in thermal injuries in vulnerable neonatal skin. We report three cases of superficial partial thickness umbilical burns in infants following such treatment that presented to a paediatric burns unit in London, UK in 2020, all from a Nigerian background. In each case, the burn wound healed with conservative management only. This is a previously unreported cause of neonatal burn injury and we aim to raise awareness of the risks that traditional cord practices may pose to the newborn.

Chronic venous disease (CVD) is a common condition that affects the veins in the lower limbs, resulting in a variety of symptoms, such as swelling, pain, and varicose veins (VVs). The plenty hormonal, hemodynamic and mechanical changes occurred in pregnancy make women especially vulnerable to suffer from this condition in this period. Previous works have identified that CVD is associated with an increased inflammatory milieu and significant damage in maternofetal tissues, such as the umbilical cord. However, the inflammatory status of this structure in these patients has not been studied yet. Thus, the aim of the present study was to examine gene and protein expression of a set of inflammatory markers—Allograft inflammatory factor 1 (AIF-1), the proinflammatory cytokines interleukin 12A (IL-12A) and IL-18 and the anti-inflammatory product IL-10—in the umbilical cord of women with CVD during pregnancy (N = 62) and healthy pregnant women (HC; N = 52) by the use of real time qPCR and immunohistochemistry (IHC). Our results demonstrate that the umbilical cord tissue from CVD women exhibit an increased expression of AIF-1, IL-12A and IL-18 along with a decrease in IL-10. Therefore, our study suggests an inflammatory status of this structure related to CVD. Further studies should be conducted to evaluate the expression of other inflammatory markers, as well as to analyze the maternofetal impact of these findings.

The objectives of the study were (1) to perform a systematic review of the available umbilical vein blood flow volume (UV-Q) reference ranges in uncomplicated pregnancies; and (2) to compare the findings of the systematic review with UV-Q values obtained from a local cohort. Available literature in the English language on this topic was identified following the PRISMA guidelines. Selected original articles were further grouped based on the UV sampling sites and the formulae used to compute UV-Q. The 50th percentiles, the means, or the best-fitting curves were derived from the formulae or the reported tables presented by authors. A prospective observational study of uncomplicated singleton pregnancies from 20+0 to 40+6 weeks of gestation was conducted to compare UV-Q with the results of this systematic review. Fifteen sets of data (fourteen sets belonging to manuscripts identified by the research strategy and one obtained from our cohort) were compared. Overall, there was a substantial heterogeneity among the reported UV-Q central values, although when using the same sampling methodology and formulae, the values overlap. Our data suggest that when adhering to the same methodology, the UV-Q assessment is accurate and reproducible, thus encouraging further investigation on the possible clinical applications of this measurement in clinical practice.

Background: Transthyretin (TTR), also known as prealbumin, has been suggested as an indicator of protein and nutritional status. Objective: The aim of this study was to examine the maternal and umbilical cord (UC) TTR in relation to intrauterine growth, and the serum TTR of preterm infants in relation to nutritional status and growth. Methods: After application of exclusion criteria, 49 preterm infants (mean gestational age and birth-weight 32.9±2.9 weeks and 1822±556 g) were included in the study. Transthyretin was sampled at birth and on days 14, 28, and at discharge with growth parameters and nutritional laboratory test results. Results: Mean UC and maternal TTR were positively correlated (8.5±2.4 mg/dL and 20.4±7.0 mg/dL, r=0.31, P=0.07). Umbilical cord TTR was neither an index of maturity nor of intrauterine growth. Umbilical cord TTR was higher in females (9.4±2.6 versus 7.6±1.8 mg/dL, P=0.015). Maternal TTR was lower in twin pregnancies (16.8±4.9 versus 22.5±7.3 mg/dL, P=0.007). Although TTR levels gradually increased over time in correlation with post-menstrual and chronological ages (r=0.24, P=0.011 and r=0.40, P

Abstract Background Japanese infants have relatively higher risk of anemia and neonatal jaundice. This study aimed to assess the effects of delayed cord clamping (DCC) on the incidence of anemia during early infancy in low-risk Japanese term infants with planned exclusive breastfeeding for 4 months. This study also aimed to explore the effects of DCC on neonatal jaundice. Methods We conducted an open-label, parallel-arm, multicenter randomized controlled trial of DCC (clamping the cord after more than a minute or pulsation stops) vs. early cord clamping (ECC; clamping the cord within 15 s) at one birth center and two clinics in Japan. Low-risk pregnant women planning to have a vaginal birth and to exclusively breastfeed and term singleton infants delivered in cephalic presentation were included in this study. The primary outcome was spectrophotometric estimation of hemoglobin at 4 months. Secondary outcomes were anemia incidence at 4 months, four outcomes related to neonatal jaundice, hematocrit levels, and related outcomes. Results Overall, 150 pregnant women were recruited. Participants (N = 138) were randomly allocated to two groups (DCC n = 68, ECC n = 70). There were no significant differences between the two groups in spectrophotometric estimation of hemoglobin at 4 months: mean difference = 0.1 g/dL, 95% confidence interval − 0.14, 0.35, DCC 12.4 g/dL, ECC 12.3 g/dL. Only the hematocrit levels on days 3 to 5 were significantly higher in the DCC group than in the ECC group: DCC 57.0%, ECC 52.6%, mean difference = 4.4, 95% confidence interval 2.61, 6.20. There were no significant differences in other secondary outcomes, including outcomes related to neonatal jaundice. Conclusion Among low-risk Japanese term infants with planned exclusive breastfeeding, DCC showed no significant effects on spectrophotometric hemoglobin levels at 4 months compared with ECC. We observed significantly higher hematocrit levels on days 3 to 5 in infants who underwent DCC, while these levels were within the normal range. Jaundice outcomes remained similar to those of infants who underwent ECC. Although a larger sample size is required to assess the effects of cord clamping on neonatal jaundice, DCC may prevent anemia in newborn infants. Trial registration UMIN-CTR; UMIN000022573, 06/01/2016 - retrospectively registered, https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000023056

Aim: To determine the reference values of strong ion difference (SID), effective SID (SIDe), unmeasured anions (UMA), tissue acids (TA), lactate and Chloride-Sodium (Cl-Na) ratio of umbilical cord blood, and to evaluate the impact of delivery mode on these parameters. Methods: This prospective study was performed on healthy term newborn infants that had normal progress throughout the first and second stages of labor during normal spontaneous delivery (NSD) and cesarean section (C/S). Immediately after birth, 1ml and 2 ml of umbilical venous cord blood samples were obtained for blood gas analysis and blood chemistry respectively. The Cl-Na ratio, anion gap (AG), albumin corrected AG (AGCorr), SID, SIDe, UMA and TA were calculated in NSD and C/S groups.. Results: A total of 181 healthy newborn infants were included the study. Fifty-one infants were delivered by NSD and 130 infants by C/S. The pH and PCO2 values were similar in both groups. The mode of delivery had a significant impact on the umbilical cord AG, AGCorr, SID, lactate, UMA, and TA levels. All these values were significantly higher in NSD than C/S group. Conclusion: Umbilical cord blood gas analysis is a common practice to evaluate fetal status at delivery. The calculation of blood gas parameters in perinatal problems according to Stewart’s method may lead further understanding how perinatal conditions of the mother influence the fetus and newborn infant.

Aim: To determine the reference values of strong ion difference (SID), effective SID (SIDe), unmeasured anions (UMA), tissue acids (TA), lactate and Chloride-Sodium (Cl-Na) ratio of umbilical cord blood, and to evaluate the impact of delivery mode on these parameters. Methods: This prospective study was performed on healthy term newborn infants that had normal progress throughout the first and second stages of labor during normal spontaneous delivery (NSD) and cesarean section (C/S). Immediately after birth, 1ml and 2 ml of umbilical venous cord blood samples were obtained for blood gas analysis and blood chemistry respectively. The Cl-Na ratio, anion gap (AG), albumin corrected AG (AGCorr), SID, SIDe, UMA and TA were calculated in NSD and C/S groups.. Results: A total of 181 healthy newborn infants were included the study. Fifty-one infants were delivered by NSD and 130 infants by C/S. The pH and PCO2 values were similar in both groups. The mode of delivery had a significant impact on the umbilical cord AG, AGCorr, SID, lactate, UMA, and TA levels. All these values were significantly higher in NSD than C/S group. Conclusion: Umbilical cord blood gas analysis is a common practice to evaluate fetal status at delivery. The calculation of blood gas parameters in perinatal problems according to Stewart’s method may lead further understanding how perinatal conditions of the mother influence the fetus and newborn infant.

Introduction: Respiratory Distress Syndrome (RDS) is a common cause of morbidity and mortality in preterm neonates. Levels of minor phospholipids and lecithin in amniotic fluid are significantly influenced by lipid metabolism. Aim: To evaluate umbilical cord lipid profile of preterm infants with RDS and normal preterm group without RDS. Materials and Methods: This was a hospital-based crosssectional study carried out in neonatal unit of at a Tertiary Care Centre at SMS Medical College, Jaipur, from June 2017 to May 2018. Out of total 80 preterm infants, 40 developed RDS and 40 infants served as controls. Umbilical cord blood lipid profile of neonates were done in both the groups and compared. Chi-Square test and unpaired Student’s t-test were used for statistical analysis. Probability was considered significant if less than 0.05 Results: Mean weight of babies was 1494.75±201.66 grams in normal preterm group and 1450.25±233.23 grams in preterm with RDS group (p=0.364). Mean gestational age was 31.45±1.36 weeks in normal preterm group and 30.98±1.49 weeks in preterm with RDS group p=0.140). Low Density Lipoprotein (LDL) and High Density Lipoprotein (HDL) were higher in male babies in both the groups as compared to female babies (p>0.05). Mean cord blood Triglyceride (TG), Total Cholesterol (TC), Very Low Density Lipoprotein (VLDL), LDL and HDL levels were significantly lower in preterms with RDS as compared to normal preterms without RDS which was statistically significant (p

OBJECTIVES: To study different umbilical cord cutting techniques prevailing among rural population of district Attock. METHODOLOGY: This descriptive cross-sectional study conducted from April - June 2017 in the rural population of district Attock. The sample size was 300 which were selected by non-probability convenient sampling technique. The data was collected over a period of three months using a pre-tested self-structured questionnaire. Informed consent was taken. Data was analyzed in SPSS version 23. RESULTS: A total number of 300 infantswere included in this study. The mean age (in days) ± SD of infants was 14.10±8.96. The mean age (in years) ±SD of mothers was 27.58±3.99. Surgical blade usage for cord cutting was 50%, 48.7% used scissors while 1.3% used knife to cut the umbilical cord after birth. 8.7% mothers applied nothing on the cord for cord care, whereas 30.7% of mothers applied domestic products on the infant’s umbilical cord which included fried onion, garlic, ghee, oil, kohl and turmeric. Chi-Square test revealed that the use of harmful domestic products was highest among the infants who were born at homes (p

INTRODUCTION: To assess the effects of umbilical cord clamping time on risk of postpartum depression. METHODS: The study included pregnant cases giving birth after 36 weeks from 24 January 2020 to 01 April 2020 in our clinic. Those with previous depression history, chronic disease, multiple pregnancy, puerperant women with impaired hemodynamics after birth, and neonates with poor Apgar score after birth or who required resuscitation were not included. The postpartum umbilical cord clamping time was classified according to the World Health Organization as late 1 minute or more and early under 1 minute. Patients were evaluated in two groups according to this grouping. During the follow-up examination performed in the postpartum 1 month, the risks in terms of postpartum depression were evaluated with the Edinburgh Postpartum Depression Scale given to the patients in the outpatient clinic. RESULTS: The study included 176 pregnant cases with birth after 36 weeks. Both groups were not observed to be different in terms of sociodemographic characteristics, obstetric history and birth information (p≥0,05). In both groups, mean EPDS points were identified as 11.07+-1.97 in the late clamping group and 13.23+-1.61 in the early clamping group and this was statistically significant (OR=6.36; p

Purpose This study aimed to identify correlations between the status of the umbilical cord and neonatal health status. Methods In total, 172 newborns were enrolled who were admitted to the newborn nursery with a gestational age of 35 weeks or older and a body weight of 2 kg or above. Data were collected on the basic personal information of the newborns, the diameter and soft tissue status of the umbilical cord, and neonatal health status after birth. Analyses were performed using t-test, analysis of variance, x2 test, and Fisher exact test. Results Umbilical cord diameter exhibited a statistically significant difference by sex (t=2.71, p=.007). A thin umbilical cord diameter was associated with a 1-minute Apgar score less than 8 points (t=2.47, p=.015) and with being transferred to the intensive care unit (t=2.45, p=.015). Poor soft tissue status of the umbilical cord was associated with a 1-minute Apgar score of less than 8 points (x2=16.68, p

Leukocyte adhesion deficiencies (LADs) are a type of primary immunodeficiencies characterized by delayed detachment of the umbilical cord, impaired wound healing, leukocytosis, and recurrent infections. The disease is caused by genetic defects affecting different steps in the process of leukocyte adhesion cascade such as rolling, integrin activation, and adhesion of leukocytes, resulting in the impairment of leukocyte trafficking. Till date, three types of LAD have been documented: type I, II and III. Type I LAD is caused by congenital defect in the b2 integrin receptor complex CD11/CD18 on the cell surface of leukocytes, which results in impaired leukocytes connection to endothelial cells and migration. Type II LAD is caused by defect in the fucose metabolism resulting in the absence of fucosylated selectin ligands on neutrophils and impaired rolling phase of the leukocyte adhesion cascade. Type III LAD is caused by mutations in the kindlin-3 gene resulting in defective integrin activation. In this article, we present a review of literature for type I LAD, and successful treatment of patient using umbilical cord blood stem cell transplantation.

Background: The umbilical cord forms connecting link between the fetus and placenta through which the fetal blood flows to and from the placenta. Its three blood vessels pass along the length of the cord in a coiled or helical fashion (spiral course). The aim of the study was to evaluate umbilical cord coiling abnormalities and determine its relationship with maternal and perinatal outcomes. Material and methods: The study included 190 patients divided into 2 groups: L1 – 95 patients with UC abnormalities and L0 – 95 with normal UC. The umbilical cord index was measured after delivery of the adnexal complex, which was defined as the total number of coils divided by the total length of the cord in centimeters. Results: The hypo- and hypercoiling umbilical cord suggests the high risk of fetal distress (p

Objective: To assess blood flow parameters as well as Doppler indices at the first six months of pregnancy in buffalo heifers. Methods: A total of 15 healthy, cycling, buffalo heifers were examined twice per month. Examination of Doppler ultrasonography started from the first month till the sixth months of pregnancy. All animals were subjected to transrectal Doppler ultrasonography to assess ovarian and uterine blood flow. Resistance index, pulsatility index, peak systolic velocity, end diastolic velocity, and blood flow rate were measured of both ipsilateral and contralateral to the fetus side. Results: The resistance index was positively correlated with the pulsatility index (r=0.62, P

Background: Perinatal hypoxic-ischemic encephalopathy (HIE) remains a major cause of neurodevelopmental impairment. Umbilical cord blood analysis provides an objective assessment of newborn metabolic status. Accordingly, it is recommended that physicians attempt to obtain venous and arterial samples when there is high risk of neonatal compromise. Objective To compare the predictive value of umbilical arterial blood pH, lactate and base deficit for subsequent development of severity of hypoxic ischemic encephalopathy (HIE) after perinatal asphyxia and comparison of these parameters to determine which one is superior in predicting severity. Methods Umbilical cord arterial blood of newborns with perinatal asphyxia was tested for pH, lactate, and base deficit estimation. These newborns were evaluated in level III NICU and divided into two groups. Group 1 had no or signs and symptoms of HIE I and group 2 had signs and symptoms of HIE II/III. Values of pH, lactate, and base deficit were tabulated and analyzed by receiver-operating characteristic curves. Optimal cut-off values were estimated based on the maximal Youden index. Results Mean pH was significantly lower in group 2 than in group 1, while lactate and base deficit were significantly higher in group 2 than in group 1. Cut-off points for determining severity of HIE were pH 6.89 mg/dL, and base deficit >7 mEq/L. Sensitivity and specificity for these cut-off points were 100% and 91.49% for pH, 100% and 85.11% for lactate, and 82.4% and 91.76% for base deficit, respectively. Predictive abilities of all three parameters were similar in determination of HIE severity. Conclusion Umbilical arterial pH, lactate, and base deficit have excellent accuracy to predict the severity of HIE. All three parameters have similarly good predictive ability.

Background: Performing Benson relaxation technique by the mother improves the labor and affects neonate. This research investigated the effect of Benson relaxation technique for mothers on infant’s umbilical arterial blood gases. Methods: In this randomized clinical trial study, 60 eligible pregnant women were selected through convenient sampling, and randomly assigned to experimental and control groups. Data collection instruments were mother’s demographic information form and neonatal information form. Benson relaxation technique were instructed to the experimental group using videos and slide presentations, and after admitting to hospital, they were encouraged to implement the noted technique. Benson relaxation technique will not be instructed to the control group. After delivery, umbilical cord of neonate was clamped at two sites, and 0.5 ml of umbilical arterial blood was collected by a trained nurse in a syringe containing heparin (< 0.1 ml), kept in an icebox, and sent to the laboratory for testing partial pressure of oxygen (PO2) and carbon dioxide (PCO2). Statistical analysis were performed using SPSS software. Findings: There was a statistically significant difference in terms of mean oxygen (P < 0.001) and carbon dioxide (P < 0.001) pressure in the umbilical artery between the control and intervention groups; the markers of the umbilical arteries of the neonate were improved in intervention group. Conclusion: Using Benson’s relaxation technique by mothers improves neonate’s arterial blood gases; and can be recommended to the healthcare system as an effective method to improve neonatal outcomes.

Abstract There are conflicting results from large randomized controlled trials in different populations regarding the effectiveness of topical application of 4% chlorhexidine to the umbilical stump of newborn infants at reducing neonatal mortality. Meta-analysis and systematic review of trials performed in South Asia and Europe support 4% chlorhexidine application to reduce neonatal mortality, whereas trials performed in Sub-Saharan Africa do not. The aim of this review is to determine the effectiveness of 4% chlorhexidine application to the umbilical stump of newborn infants born in lower income countries in order to reduce neonatal mortality when compared with usual cord care. Our search strategy included randomized trials published between January1st 2000 and September 4th, 2018, that compared 4% chlorhexidine with usual cord care (“dry cord care”). The outcome variable of interest was neonatal mortality. Pooled relative risks (RR) with 95% confidence intervals (CIs) using a random-effects model were calculated. Nine trials were included, from six countries: Zambia, Tanzania, Bangladesh, Nepal, India and Pakistan, with a total of 257,153 participants. Five studies (N = 119,833) reported neonatal mortality. There was a 21% reduction in neonatal mortality among with 4% chlorhexidine application: pooled RR (95% CI) 0.79 (0.69–0.90), P = 0.0005. The incidence of omphalitis was decreased by 35% with 4% chlorhexidine (6 studies, N = 108,263): pooled RR (95% CI) 0.65 (0.56–0.75), P = 0.00001. Chlorhexidine application delayed the umbilical cord separation time (4 studies, N = 28,917): mean difference (95% CI) 2.71 (2.63–2.78) days. In conclusion, this systematic review found that topical application of 4% chlorhexidine to the umbilical cord stump of newborn infants in lower income countries significantly reduces the incidence of neonatal mortality. Chlorhexidine also reduces the incidence of omphalitis, but prolongs umbilical cord separation time. Trial registration Systematic Review Registration: CRD42018109280 .

(1) Background: Sensorineural hearing loss is a common and debilitating condition. To date, comprehensive pharmacologic interventions are not available. The complex and diverse molecular pathology that underlies hearing loss may limit our ability to intervene with small molecules. The current review foccusses on the potential for the use of extracellular vesicles in neurotology. (2) Methods: Narrative literature review. (3) Results: Extracellular vesicles provide an opportunity to modulate a wide range of pathologic and physiologic pathways and can be manufactured under GMP conditions allowing for their application in the human inner ear. The role of inflammation in hearing loss with a focus on cochlear implantation is shown. How extracellular vesicles may provide a therapeutic option for complex inflammatory disorders of the inner ear is discussed. Additionally, manufacturing and regulatory issues that need to be addressed to develop EVs as advanced therapy medicinal product for use in the inner ear are outlined. (4) Conclusion: Given the complexities of inner ear injury, novel therapeutics such as extracellular vesicles could provide a means to modulate inflammation, stress pathways and apoptosis in the inner ear.

Abstract Simultaneous presentation of omphalocele, patent urachus, and umbilical cyst is very rare. There is wide range of differential diagnosis for umbilical cyst. Accurate assessment of umbilical cysts is important to evaluate other abnormalities.

Umbilical cord platelet-rich plasma (C-PRP) has more growth factors and anti-inflammatory molecules compared with autologous PRP (A-PRP) derived from peripheral blood. The aim of this study was to compare intra-articular C-PRP or A-PRP injections in terms of safety and clinical efficacy for the treatment of patients with hip osteoarthritis (OA). This study investigated the results of 100 patients with hip OA treated with three weekly ultrasound-guided injections of either C-PRP or A-PRP. Clinical evaluations were performed before the treatment and after two, six, and twelve months with the HHS, WOMAC, and VAS scores. No major adverse events were recorded. Overall, the improvement was limited with both treatments. Significant improvements in VAS (p = 0.031) and HHS (p = 0.011) were documented at two months for C-PRP. Patients with a low OA grade (Tonnis 1-2) showed a significantly higher HHS improvement with C-PRP than A-PRP at twelve months (p = 0.049). C-PRP injections are safe but offered only a short-term clinical improvement. The comparative analysis did not demonstrate benefits compared with A-PRP in the overall population, but the results are influenced by OA severity, with C-PRP showing more benefits when advanced OA cases were excluded. Further studies are needed to confirm the most suitable indications and potential of this biological injective approach.

Abstract Our case was a newborn with two umbilical knots that delivered 39 weeks gastation and did not experience any developmental disruptions. The risk factors of fetus for true knot formation in the umbilical cord were gender and the umbilical cord size.

Congenital hernia of the umbilical cord (CHUC) is a rare, distinctive anomaly with variable presentation and conflicting terminology. We report two newborn infants who had fetal antenatal diagnosis as umbilical cord cyst and omphalocele, respectively, and were subsequently found to have hernia into the umbilical cord. The herniating mass in CHUC may vary greatly in size, making it difficult to differentiate with other conditions such as congenital umbilical cord cyst, cord hematoma, omphalocele, and gastroschisis. CHUC is prone to inadvertent cord clamping and injury to the gut. The failure of retraction of intestinal loops following physiological herniation has been postulated as the embryological basis of this entity. Overall prognosis is good.

Abstract An umbilical cord knot is an unexpected event that should not change obstetric approach for delivery.

Abstract Background Experiments have shown improved cardiovascular stability in lambs if umbilical cord clamping is postponed until positive pressure ventilation is started. Studies on intact cord resuscitation on human term infants are sparse. The purpose of this study was to evaluate differences in clinical outcomes in non-breathing infants between groups, one where resuscitation is initiated with an intact umbilical cord (intervention group) and one group where cord clamping occurred prior to resuscitation (control group). Methods Randomized controlled trial, inclusion period April to August 2016 performed at a tertiary hospital in Kathmandu, Nepal. Late preterm and term infants born vaginally, non-breathing and in need of resuscitation according to the ‘Helping Babies Breathe’ algorithm were randomized to intact cord resuscitation or early cord clamping before resuscitation. Main outcome measures were saturation by pulse oximetry (SpO2), heart rate and Apgar at 1, 5 and 10 minutes after birth. Results At 10 minutes after birth, SpO2 (SD) was significantly higher in the intact cord group compared to the early cord clamping group, 90.4 (8.1) vs 85.4 (2.7) %, P

The embryonic development of the human umbilical cord (hUC) is complex, and different regions can be identified in this structure. The aim of this work is to characterize the hUC at in situ and ex vivo levels to stablish their potential use in vascular regeneration. Human umbilical cords were obtained and histologically prepared for in the situ analysis of four hUC regions (intervascular—IV, perivascular—PV, subaminoblastic—SAM, and Wharton’s jelly—WH), and primary cell cultures of mesenchymal stem cells (hUC-MSC) isolated from each region were obtained. The results confirmed the heterogeneity of the hUC, with the IV and PV zones tending to show the higher in situ expression of several components of the extracellular matrix (collagens, proteoglycans, and glycosaminoglycans), vimentin, and MSC markers (especially CD73), although isolation and ex vivo culture resulted in a homogeneous cell profile. Three vascular markers were positive in situ, especially vWF, followed by CD34 and CD31, and isolation and culture revealed that the region associated with the highest expression of vascular markers was IV, followed by PV. These results confirm the heterogeneity of the hUC and the need for selecting cells from specific regions of the hUC for particular applications in tissue engineering.

BBackground and Aim: Ischemic heart diseases are the most common cause of mortality and morbidity in developed countries. The incidence of these disorders are increasing and the age of onset is on the decrease. The prevalence of risk factors such as obesity and hyperlipidemia is on the increase among children and adolescents. Various maternal and fetal factors can affect fetal fat levels. Therefore, the present study was designed to determine the relationship of the level of umbilical cord blood lipids with gestational age and birth weight in the newborns born in Mahdieh Hospital in 2017. Material and Method: In this descriptive-analytical study we measured cord blood lipids levels of 375 newborns, born in Mahdieh Hospital in 2017. Newborns with known maternal or fetal complications were excluded from the study. Demographic, clinical and paraclinical data of the newborns and mothers were recorded in the questionnaire for every newborn and the relationship of the level of umbilical cord blood lipids (total cholesterol, VLDL, HDL, LDL, and triglyceride) with gestational age, birth weight, sex of the newborn, maternal age and BMI was evaluated. We used chi-square test to compare qualitative data and T-test, ANOVA, Kruskal-Wallis and Spearman correlation coefficient to compare quantitative data. Results: This study included 375 single-birth infants (191 girls and 184 boys). The mean umbilical cord serum values for triglyceride in the preterm and term infants were 122.2±31.2 and 97.6±31.7 (p

A patent urachus is the presence of structures found early in pregnancy, which could be associated with other abnormality in 46% cases. Hemangiomas are benign tumors and are more common in the skin. Umbilical cord hemangiomas are very rare, with fewer than 50 cases described in the literature. Here we report a clinical case of a neonate with a prenatal diagnosis of an umbilical cord hemangioma and a patent urachus. We would like to draw attention to the differential diagnosis of cord masses, as well as to the importance of early diagnosis and the appropriate management of the newborn. To our knowledge, this is the first case reported of a newborn diagnosed with this association.

High levels of proteins called proteoglycans in the walls of umbilical arteries enable these arteries to close rapidly after birth and thus prevent blood loss in newborns.