Letter to the Editor

Excerpt

We report on 2 additional cases of corkscrew-like malformation of the umbilical cord as presented by Dargent et al. [1]. Case 1 was a 15.5-week fetus after spontaneous abortion. The specimen consisted of an unopened amniotic sac that contained a macerated male fetus that weighed 34 g (normal for gestational age 80 g) with a crown-to-heel length of 11 cm. There were no internal or external malformations. Placental weight was 55 g (normal for gestational age 110 g). The umbilical cord was centrally inserted and measured 11 cm in length. It was obviously overcoiled and the corkscrew-like malformation was 5 cm from the placental insertion and 5.5 cm from the fetal insertion, protruded at a right angle to the rest of the cord, and was 5 cm long (Fig. 1A). The total length of the cord was estimated at 20 cm. Histologic sections of the cord showed advanced autolysis but 3 vessels were clearly identified. Notably, the placenta showed foci of histiocytic and granulomatous perivillitis mainly involving the outer third of the placental tissue, i.e., villi on the maternal side. No organisms were found. The case was interpreted as representing a stillborn macerated fetus whose weight was low for gestational age associated with a placenta whose weight was low for gestational age and had histiocytic and granulomatous perivillitis and a long overcoiled umbilical cord with a corkscrew segment. Case 2 was a 30-year-old female with 1 previous termination of pregnancy. The current pregnancy was complicated by severe eclampsia and hemolysis. Cesarian section was performed at 35 weeks of gestation due to chronic fetal distress, and a female infant with a weight of 2,170 g and Apgar scores of 7 and 9 was delivered. The placenta weighed 520 g and the umbilical cord showed a corkscrew-like malformation that was 17 cm from the eccentric placental insertion and measured 4 cm in length. The 25-cm umbilical cord was extensively hypercoiled and was apparently coiled on the appendage (Fig 1B), akin to a telephone wire coiling. Sectioning showed 3 vessels in multiple sections. The placenta showed multiple infarcts and multifocal intervillositis without organisms.

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