Marie Driver

An angiomyxoma involving the whole length of the umbilical cord. Prenatal diagnosis by ultrasonography.

The discovery of an umbilical cord angiomyxoma or hemangioma is a rare event. Heifetz and Rueda-pedraya have found 19 pathologic descriptions of this tumor published in the world literature since the beginning of this century.1 Improvement and wide use of ultrasound techniques in antenatal care have made the prenatal diagnosis of this lesion possible.2 This report describes an unusually extended angiomyxoma with progressive shortening of the umbilical cord associated with raised maternal serum alpha-fetoprotein and superficial angiomas of the infants skin. The lesion was followed by ultrasound from 20 weeks gestation until delivery.

Perfusion fixation for placental morphologic investigation

Fifty placentas were collected after vaginal delivery or cesarean section from normal and abnormal pregnancies and were fixed under different conditions of perfusion using a peristaltic roller pump. In each case a physiologic-heparin perfusate was used for less than 10 minutes, followed by a buffered solution of glutaraldehyde-formaldehyde. The best results were obtained with placentas from cesarean sections perfused immediately after delivery with a pressure maintained under 60 mm Hg. Placentas of this group were fixed within 30 minutes and electron microscopy demonstrated good preservation of cellular ultrastructure. Perfusion fixation could be performed up to 6 hours after delivery with satisfactory histologic results. In these cases, electron microscopy revealed ischemic changes 10 minutes after delivery and severe necrosis 1 hour after delivery. When the perfusion pressure was maintained over 60 mm Hg, diffuse damage of the villous morphology was observed. Histomorphometric analysis showed significant differences between terminal villi from nonperfused (immersed-fixed) placentas and perfused-fixed placentas. The mean barrier and trophoblastic thicknesses and the mean volume fraction of trophoblast were significantly (P less than .001) increased in the nonperfused group compared with the perfused group.

Morphometry of the Second Trimester Fetal Brain

With the increasing use of ultrasound examination in the antenatal period the lack of morphological correlates has become a problem. This study was carried out in order to correct this deficiency. An antenatal real-time ultrasound scan of the fetal head was performed and measurements of the biparietal diameter, occipitofrontal diameter, head circumference and cerebral ventricle-to-hemisphere ratio were undertaken in 103 fetuses at 13–24 weeks gestation. After prostaglandin termination of pregnancy, the fetal brains were perfused in situ through the right carotid artery with 10% formal saline. Horizontal slices of the fetal head were cut, photographs were obtained and measurements of the same parameters as in the ultrasound examination were undertaken. There is a significant correlation (p