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LETTER TO THE EDITOR
Year : 2019  |  Volume : 8  |  Issue : 13  |  Page : 43

Umbilical cord thrombosis, a cause of intrauterine fetal demise: A case study


Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq

Date of Web Publication19-Feb-2019

Correspondence Address:
Mahmood Dhahir Al-Mendalawi
Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, P. O. Box: 55302, Baghdad Post Office, Baghdad
Iraq
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/nnjcr.nnjcr_26_18

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How to cite this article:
Al-Mendalawi MD. Umbilical cord thrombosis, a cause of intrauterine fetal demise: A case study. N Niger J Clin Res 2019;8:43

How to cite this URL:
Al-Mendalawi MD. Umbilical cord thrombosis, a cause of intrauterine fetal demise: A case study. N Niger J Clin Res [serial online] 2019 [cited 2021 Apr 18];8:43. Available from: https://www.mdcan-uath.org/text.asp?2019/8/13/43/252583



Sir,

I read with interest the case report on the umbilical cord thrombosis (UCT) in a Nigerian mother with intrauterine fetal death.[1] I presume that the authors did not consider the contributory role of infection with human immunodeficiency virus (HIV) to the development of UCT. It is noteworthy that there is an established correlation between HIV and the vascular system, which is characterized by various clinical manifestations of the occlusive and aneurysmal disease. The exact pathogenesis is still obscure. However, the available evidence pointed out to leukocytoclastic vasculitis with the vaso vasora as the vasculopathic epicenter.[2] It was suggested that HIV itself or viral proteins could activate the release of different inflammatory mediators causing endothelial dysfunction and smooth muscle proliferation resulting in vascular injury and thrombosis.[2] To my knowledge, Nigeria is among sub-Saharan countries markedly affected with HIV epidemic. The available data pointed out that 3% of Nigerian women who were HIV-negative at booking visit tested positive (seroconverted) to HIV.[3] I presume that some sort of the aforementioned HIV-associated pathological changes had probably occurred in the placental vasculature and umbilical cord vessels. Regrettably, the HIV status of the mother was not determined. Accordingly, I presume that the arrangement for the diagnostic workup of viral overload and CD4 count estimations was envisaged. If that workup was performed and it revealed HIV infection, the case in question could be surely considered a novel case report. This is because HIV-associated UCT resulting in fetal demise has never been reported in the published literature to date.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Iwunze EC, Iwunze CI. Umbilical cord thrombosis, a cause of intra-uterine fetal demise: A case study. N Niger J Clin Res 2018;7:32-4.  Back to cited text no. 1
  [Full text]  
2.
Pillay B, Ramdial PK, Naidoo DP. HIV-associated large-vessel vasculopathy: A review of the current and emerging clinicopathological spectrum in vascular surgical practice. Cardiovasc J Afr 2015;26:70-81.  Back to cited text no. 2
    
3.
Nyoyoko NP, Umoh AV. The prevalence and determinants of HIV seroconversion among booked ante natal clients in the University of Uyo Teaching Hospital, Uyo Akwa Ibom state, Nigeria. Pan Afr Med J 2016;25:247.  Back to cited text no. 3
    




 

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