PDF(Pubmed)
Abstract：
UNASSIGNED: Umbilical artery thrombosis (UAT) is a rare complication of pregnancy and is associated with adverse pregnancy outcomes, including fetal intrauterine distress, intrauterine growth restriction, and still birth. UAT is unpredictable, and prenatal diagnosis is challenging. There is no consensus on the treatment strategy of UAT, especially for patients with prenatal detection of one of the umbilical artery embolisms. In most previous cases, an emergency cesarean section was performed, or intrauterine fetal death occurred at the time of UAT diagnosis.
UNASSIGNED: In this report, we describe a case of thrombosis in one of the umbilical arteries detected by routine ultrasonography at 31+3 weeks of gestation in a 34-year-old woman. Following expectant management with intensive monitoring for 4 four days, an emergency cesarean section was performed because of abnormal fetal umbilical cord blood flow and middle cerebral artery blood flow; the newborn was in good condition at birth. The final umbilical cord histopathology revealed thrombosis in one of the umbilical arteries. Both mother and newborn described in this case underwent long-term follow-up for nearly 2 two years and are currently in good health without any complications.
UNASSIGNED: Based on our experience, obstetricians should comprehensively consider the current gestational age and fetal intrauterine status when UAT is suspected to determine the best delivery time. The appropriate gestational age should be prolonged as long as the mother and fetus are stable when the fetus is immature, trying our best to complete the corticosteroid treatment to promote fetal lung maturity and magnesium sulfate to protect fetal brain. During expectant management, ultrasound monitoring, electronic fetal heart monitoring, and fetal movement counting should be strengthened. Clinicians should ensure that the patients and their families are informed about all potential risks of expectant management for UAT.
UNASSIGNED: In this report, we describe a case of thrombosis in one of the umbilical arteries detected by routine ultrasonography at 31+3 weeks of gestation in a 34-year-old woman. Following expectant management with intensive monitoring for 4 four days, an emergency cesarean section was performed because of abnormal fetal umbilical cord blood flow and middle cerebral artery blood flow; the newborn was in good condition at birth. The final umbilical cord histopathology revealed thrombosis in one of the umbilical arteries. Both mother and newborn described in this case underwent long-term follow-up for nearly 2 two years and are currently in good health without any complications.
UNASSIGNED: Based on our experience, obstetricians should comprehensively consider the current gestational age and fetal intrauterine status when UAT is suspected to determine the best delivery time. The appropriate gestational age should be prolonged as long as the mother and fetus are stable when the fetus is immature, trying our best to complete the corticosteroid treatment to promote fetal lung maturity and magnesium sulfate to protect fetal brain. During expectant management, ultrasound monitoring, electronic fetal heart monitoring, and fetal movement counting should be strengthened. Clinicians should ensure that the patients and their families are informed about all potential risks of expectant management for UAT.
摘要：
■脐动脉血栓形成（UAT）是一种罕见的妊娠并发症，与不良妊娠结局有关，包括胎儿宫内窘迫,宫内生长受限,仍然出生。UAT是不可预测的，产前诊断是具有挑战性的。对UAT的治疗策略没有共识，尤其是对有脐动脉栓塞产前检测的患者。在大多数以前的情况下，进行了紧急剖宫产,或宫内胎儿死亡发生在UAT诊断时。
■在本报告中，我们描述了一例34岁女性在妊娠31+3周时通过常规超声检查发现的其中一条脐动脉血栓形成的病例.经过预期管理和4天的密集监测，由于胎儿脐带血流和大脑中动脉血流异常，进行了紧急剖宫产；新生儿出生时状况良好。最终的脐带组织病理学显示其中一个脐动脉血栓形成。在这种情况下，母亲和新生儿都接受了将近2年的长期随访，目前身体健康，没有任何并发症。
■根据我们的经验，在怀疑UAT时，产科医生应综合考虑当前的胎龄和胎儿宫内状况，以确定最佳分娩时间。在胎儿未成熟时,只要母亲和胎儿稳定,应延长适当的胎龄,尽最大努力完成皮质类固醇治疗促进胎儿肺成熟和硫酸镁保护胎儿大脑。在期待管理期间，超声监测,电子胎心监护,应加强胎动计数。临床医生应确保患者及其家人了解UAT预期管理的所有潜在风险。
■在本报告中，我们描述了一例34岁女性在妊娠31+3周时通过常规超声检查发现的其中一条脐动脉血栓形成的病例.经过预期管理和4天的密集监测，由于胎儿脐带血流和大脑中动脉血流异常，进行了紧急剖宫产；新生儿出生时状况良好。最终的脐带组织病理学显示其中一个脐动脉血栓形成。在这种情况下，母亲和新生儿都接受了将近2年的长期随访，目前身体健康，没有任何并发症。
■根据我们的经验，在怀疑UAT时，产科医生应综合考虑当前的胎龄和胎儿宫内状况，以确定最佳分娩时间。在胎儿未成熟时,只要母亲和胎儿稳定,应延长适当的胎龄,尽最大努力完成皮质类固醇治疗促进胎儿肺成熟和硫酸镁保护胎儿大脑。在期待管理期间，超声监测,电子胎心监护,应加强胎动计数。临床医生应确保患者及其家人了解UAT预期管理的所有潜在风险。
