Abstract：
BACKGROUND: Stricture of the umbilical cord, though a rare condition, is one of the critical events that can be associated with intrauterine fetal death.
METHODS: A 27-year-old woman, primigravida, presented with USG report of fetus mortus at 37 weeks of gestation. There were no preceding warning signs. Postmortal examination showed Grade II macerated female fetus weighing 2372 g, measuring 49 cm, with haemorrhagic fluid in the brain ventricles. Microscopically, there were signs of amniotic fluid aspiration and autolytic changes. The macroscopic placental examination was normal, while signs of intrauterine asphyxia and intrauterine fetal demise were present histologically. Umbilical cord insertion was eccentric, on the cut three-vessel cord, 49 cm long, 1 cm in diameter. Extremely narrow segment measured 3 mm, approximately 1,5 cm in length, and was located 1 cm from fetal insertion site. In the further course, hypercoiling in 12 cm of the length was present. Examination of umbilical cord in stricture area revealed loss of Wharton\'s jelly, replacement with extensive fibrosis and capillary vessel formation.
CONCLUSIONS: The causality between umbilical cord stricture and intrauterine fetal demise has been established. Etiology is still unclear, therefore postmortal examination with umbilical cord evaluation and further research are needed.
METHODS: A 27-year-old woman, primigravida, presented with USG report of fetus mortus at 37 weeks of gestation. There were no preceding warning signs. Postmortal examination showed Grade II macerated female fetus weighing 2372 g, measuring 49 cm, with haemorrhagic fluid in the brain ventricles. Microscopically, there were signs of amniotic fluid aspiration and autolytic changes. The macroscopic placental examination was normal, while signs of intrauterine asphyxia and intrauterine fetal demise were present histologically. Umbilical cord insertion was eccentric, on the cut three-vessel cord, 49 cm long, 1 cm in diameter. Extremely narrow segment measured 3 mm, approximately 1,5 cm in length, and was located 1 cm from fetal insertion site. In the further course, hypercoiling in 12 cm of the length was present. Examination of umbilical cord in stricture area revealed loss of Wharton\'s jelly, replacement with extensive fibrosis and capillary vessel formation.
CONCLUSIONS: The causality between umbilical cord stricture and intrauterine fetal demise has been established. Etiology is still unclear, therefore postmortal examination with umbilical cord evaluation and further research are needed.
摘要：
背景：脐带狭窄，虽然是罕见的情况，是与胎儿宫内死亡相关的关键事件之一。
方法：一位27岁的女性，primigravida,提交了USG妊娠37周时胎儿的报告。之前没有警告信号。产后检查显示II级浸软的女性胎儿，体重2372克，49厘米，脑室有出血液.微观上,有羊水抽吸和自溶改变的迹象。宏观胎盘检查正常，而组织学上存在宫内窒息和胎儿宫内死亡的迹象。脐带插入偏心，在切断的三血管绳上，49厘米长，直径1厘米。极窄段测量为3毫米，大约1.5厘米长，位于距胎儿插入部位1厘米处。在进一步的过程中，在12厘米的长度上存在超卷。在狭窄区域的脐带检查显示沃顿的果冻丢失，替代广泛的纤维化和毛细血管形成。
结论：脐带狭窄与胎儿宫内死亡之间的因果关系已经确定。病因尚不清楚,因此，需要进行脐带评估和进一步研究。
方法：一位27岁的女性，primigravida,提交了USG妊娠37周时胎儿的报告。之前没有警告信号。产后检查显示II级浸软的女性胎儿，体重2372克，49厘米，脑室有出血液.微观上,有羊水抽吸和自溶改变的迹象。宏观胎盘检查正常，而组织学上存在宫内窒息和胎儿宫内死亡的迹象。脐带插入偏心，在切断的三血管绳上，49厘米长，直径1厘米。极窄段测量为3毫米，大约1.5厘米长，位于距胎儿插入部位1厘米处。在进一步的过程中，在12厘米的长度上存在超卷。在狭窄区域的脐带检查显示沃顿的果冻丢失，替代广泛的纤维化和毛细血管形成。
结论：脐带狭窄与胎儿宫内死亡之间的因果关系已经确定。病因尚不清楚,因此，需要进行脐带评估和进一步研究。
