ISSN 0253-2778

CN 34-1054/N

Open AccessOpen Access JUSTC Original Paper

The risk factors and perinatal outcomes of umbilical vessels thrombosis

Cite this:
https://doi.org/10.3969/j.issn.0253-2778.2020.07.010
  • Received Date: 09 May 2020
  • Accepted Date: 18 July 2020
  • Rev Recd Date: 18 July 2020
  • Publish Date: 31 July 2020
  • Objective: The aim of this study is to examine the association between the various risk factors associated with umbilical cord thrombosis, and to evaluate perinatal outcomes. Methods: A retrospective study of umbilical cord thrombi enrolled between 2015~2018 was carried out. Data were analyzed from the medical archives of Tongji Hospital, Huazhong University of Science and Technology. The diagnoses of all cases were confirmed by histopathology. Results:5 of 8 cases were umbilical vein embolism and 3 were umbilical vein thrombi. Gross examination reported 6 cases of additional cord abnormalities, including 2 cases of anomalous of umbilical cord lengths, 2 cases of hyper-coiling, 1 case of swollen cord with deficiency of Wharton’s jelly, and 1 case of placenta velamentous. There are 4 cases termed gestational diabetes disorders, including 3 were gestational diabetes mellitus and one had a history of type I diabetes. Clinical findings depicted that the chief complaint of 4 patients was decreased fetal movement, 3 patients were unsatisfied with electronic fetal monitoring (EFM) and 1 was routine delivery. Perinatal outcomes: With the exception of 2 stillbirths, the remaining 6 cases were terminated by cesarean section. Six infants are alive, including one was SGA(small for gestational age),one was LBW(low birth weight)and one was VLBW that all infants transferred to neonatology department. Conclusion: We have observed that umbilical structural dysplasia and abnormal blood glucose may lead to the formation of thrombosis. Focus on important signs from prenatal ultrasound, EFM tests and fetal movements can help in improving the screening rate of umbilical cord thrombi. Our results support in the more effective approach of performing emergency cesarean section as soon as possible completed with antenatal corticosteroid therapy for fetal lung maturation in the third trimester.
    Objective: The aim of this study is to examine the association between the various risk factors associated with umbilical cord thrombosis, and to evaluate perinatal outcomes. Methods: A retrospective study of umbilical cord thrombi enrolled between 2015~2018 was carried out. Data were analyzed from the medical archives of Tongji Hospital, Huazhong University of Science and Technology. The diagnoses of all cases were confirmed by histopathology. Results:5 of 8 cases were umbilical vein embolism and 3 were umbilical vein thrombi. Gross examination reported 6 cases of additional cord abnormalities, including 2 cases of anomalous of umbilical cord lengths, 2 cases of hyper-coiling, 1 case of swollen cord with deficiency of Wharton’s jelly, and 1 case of placenta velamentous. There are 4 cases termed gestational diabetes disorders, including 3 were gestational diabetes mellitus and one had a history of type I diabetes. Clinical findings depicted that the chief complaint of 4 patients was decreased fetal movement, 3 patients were unsatisfied with electronic fetal monitoring (EFM) and 1 was routine delivery. Perinatal outcomes: With the exception of 2 stillbirths, the remaining 6 cases were terminated by cesarean section. Six infants are alive, including one was SGA(small for gestational age),one was LBW(low birth weight)and one was VLBW that all infants transferred to neonatology department. Conclusion: We have observed that umbilical structural dysplasia and abnormal blood glucose may lead to the formation of thrombosis. Focus on important signs from prenatal ultrasound, EFM tests and fetal movements can help in improving the screening rate of umbilical cord thrombi. Our results support in the more effective approach of performing emergency cesarean section as soon as possible completed with antenatal corticosteroid therapy for fetal lung maturation in the third trimester.
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  • [1]
    DUSSAUX C, PICONE O, CHAMBON G, et al. Umbilical vein thrombosis: to deliver or not to deliver at the time of diagnosis?[J]. Clinical Case Reports, 2014, 2(6):271-273.
    [2]
    LUTFALLAH F, OUFKIR N, MARKOU G A, et al. A case of umbilical artery thrombosis in the third trimester of pregnancy[J]. American Journal of Case Reports, 2018, 19:72-75.
    [3]
    孙倩, 金镇. 脐血管栓塞的诊治现状[J]. 现代妇产科进展, 2019, 28(05):75-77.
    [4]
    REDLINE R W. Inflammatory responses in the placenta and umbilical cord[J]. Seminars in Fetal & Neonatal Medicine, 2006, 11(5):296-301.
    [5]
    DONEPUDI R V, MOISE K J. Intrauterine transfusion complicated by umbilical artery thrombosis[J]. Case Reports in Obstetrics and Gynecology, 2019, 2019:1-4.
    [6]
    ALI A, SUNIL J, EDGAR H A, et al. Umbilical artery thrombosis with associated acute and severe fetal growth restriction and transient severe protein S deficiency: Report of a case with prenatal ultrasound diagnosis allowing for timely intervention and good outcome[J]. Case Reports in Obstetrics and Gynecology, 2018, 2018:1-3.
    [7]
    JAMES A H. Thrombosis in pregnancy and maternal outcomes[J]. Birth Defects Research Part C: Embryo Today: Reviews, 2015, 105(3):159-166.
    [8]
    FRITZ M A, CHRISTOPHER C R. Umbilical vein thrombosis and maternal diabetes mellitus[J]. The Journal of reproductive medicine, 1981, 26(6):320-324.
    [9]
    林仙方, 陈晖, 应微微, 等. 产前超声诊断脐血管栓塞1例[J]. 中华超声影像学杂志, 2017, 026(10):838-844.
    [10]
    伍霞芳, 应微微, 朱悠悠. 产前超声诊断脐动脉急性栓塞3例[J]. 中国超声医学杂志, 2016, 32(4):370.
    [11]
    KANENISHI K, NITTA E, MASHIMA M, et al. HDlive imaging of intra-amniotic umbilical vein varix with thrombosis[J]. Placenta, 2013, 34(11):1110-1112.
    [12]
    LI H X, WU Q F, et al. Umbilical artery thrombosis: Two case reports[J]. Medicine, 2019, 98(48):e18170.
    [13]
    李欢喜, 吴泉锋, 魏玮, 等. 单胎产前超声诊断单脐动脉352例临床分析[J]. 实用妇产科杂志, 2019, 35(6):463-466.
    [14]
    TANAKA K, TANIGAKI S, MATSUSHIMA M, et al. Prenatal diagnosis of umbilical artery thrombosis[J]. Fetal Diagnosis & Therapy, 2014, 35(2):148-150.)
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    [1]
    DUSSAUX C, PICONE O, CHAMBON G, et al. Umbilical vein thrombosis: to deliver or not to deliver at the time of diagnosis?[J]. Clinical Case Reports, 2014, 2(6):271-273.
    [2]
    LUTFALLAH F, OUFKIR N, MARKOU G A, et al. A case of umbilical artery thrombosis in the third trimester of pregnancy[J]. American Journal of Case Reports, 2018, 19:72-75.
    [3]
    孙倩, 金镇. 脐血管栓塞的诊治现状[J]. 现代妇产科进展, 2019, 28(05):75-77.
    [4]
    REDLINE R W. Inflammatory responses in the placenta and umbilical cord[J]. Seminars in Fetal & Neonatal Medicine, 2006, 11(5):296-301.
    [5]
    DONEPUDI R V, MOISE K J. Intrauterine transfusion complicated by umbilical artery thrombosis[J]. Case Reports in Obstetrics and Gynecology, 2019, 2019:1-4.
    [6]
    ALI A, SUNIL J, EDGAR H A, et al. Umbilical artery thrombosis with associated acute and severe fetal growth restriction and transient severe protein S deficiency: Report of a case with prenatal ultrasound diagnosis allowing for timely intervention and good outcome[J]. Case Reports in Obstetrics and Gynecology, 2018, 2018:1-3.
    [7]
    JAMES A H. Thrombosis in pregnancy and maternal outcomes[J]. Birth Defects Research Part C: Embryo Today: Reviews, 2015, 105(3):159-166.
    [8]
    FRITZ M A, CHRISTOPHER C R. Umbilical vein thrombosis and maternal diabetes mellitus[J]. The Journal of reproductive medicine, 1981, 26(6):320-324.
    [9]
    林仙方, 陈晖, 应微微, 等. 产前超声诊断脐血管栓塞1例[J]. 中华超声影像学杂志, 2017, 026(10):838-844.
    [10]
    伍霞芳, 应微微, 朱悠悠. 产前超声诊断脐动脉急性栓塞3例[J]. 中国超声医学杂志, 2016, 32(4):370.
    [11]
    KANENISHI K, NITTA E, MASHIMA M, et al. HDlive imaging of intra-amniotic umbilical vein varix with thrombosis[J]. Placenta, 2013, 34(11):1110-1112.
    [12]
    LI H X, WU Q F, et al. Umbilical artery thrombosis: Two case reports[J]. Medicine, 2019, 98(48):e18170.
    [13]
    李欢喜, 吴泉锋, 魏玮, 等. 单胎产前超声诊断单脐动脉352例临床分析[J]. 实用妇产科杂志, 2019, 35(6):463-466.
    [14]
    TANAKA K, TANIGAKI S, MATSUSHIMA M, et al. Prenatal diagnosis of umbilical artery thrombosis[J]. Fetal Diagnosis & Therapy, 2014, 35(2):148-150.)

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