Umbilical cord thrombosis and chorioamnionitis in neonatal arterial ischaemic stroke

A baby boy was delivered at term by emergency caesarean section because of abnormal fetal heart rate patterns during spontaneous labour. The umbilical cord arterial blood obtained at delivery had a pH of 6.97 and a lactate concentration of 12.1 mmol/L. The Apgar scores were 3 and 7, respectively, at 1 and 5 min. The proximal umbilical cord had a thrombotic aspect at delivery (figure 1). A thrombus was also identified in the ductus venosus at 1 hour of life. The boy presented left hemicorporeal seizures at 21 hours of life, which revealed a neonatal arterial ischaemic stroke (NAIS; figure 2). Placental histology revealed acute chorioamnionitis (). Screening for thrombophilia was negative in the boy and his mother.1 The pathophysiology of NAIS remains unclear but may be multifactorial.2 Two main mechanisms of NAIS are currently suspected: a cerebral embolism of a placental thrombosis and...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - Category: Perinatology & Neonatology Authors: Tags: Open access Images in neonatal medicine Source Type: research