Umbilical cord thrombosis and chorioamnionitis in neonatal arterial ischaemic stroke

• Published in: Archives of disease in childhood. Fetal and neonatal edition Vol. 108; no. 1; pp. 77 - 78
• Main Authors: Dridi, Maroa, Chabrier, Stéphane, Raia-Barjat, Tiphaine, Giraud, Antoine
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 01.01.2023; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Apgar score; Brain Ischemia; Chorioamnionitis - diagnosis; Clinical practice guidelines; Female; Fetal Blood; Heart rate; Humans; Images in Neonatal Medicine; Infant, Newborn; Infant, Newborn, Diseases; Inflammation; Ischemia; Ischemic Stroke; neonatology; Newborn babies; pathology; Pediatrics; Pregnancy; Risk factors; Stroke; Stroke - diagnosis; Stroke - etiology; Thromboembolism; Thrombosis; Thrombosis - complications; Thrombosis - diagnosis; Umbilical Cord; neonatology; pathology
• ISSN: 1359-2998; 1468-2052
• DOI: 10.1136/archdischild-2021-322143

Correspondence to Dr Antoine Giraud, Neonatal Intensive Care Unit, Saint-Étienne University Hospital Center, 42055 Saint-Étienne, France; antoine.giraud@univ-st-etienne.fr A baby boy was delivered at term by emergency caesarean section because of abnormal fetal heart rate patterns during spontaneous labour. 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 a focal cerebral arteritis secondary to chorioamnionitis.3 However, the intuitive embolic hypothesis is challenged,3 and perinatal inflammation is consistently reported as a major independent risk factor of NAIS in recent case–control studies.3 4 The baby combined a lot of NAIS risk factors: nulliparity, male sex, multiple markers of difficulty with transition—fetal heart rate abnormality, emergency caesarean section, low Apgar score, low umbilical artery pH—and perinatal inflammation.2–4 Proximal umbilical cord thrombosis is highly unusual and has never been described in NAIS. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.