A case report of umbilical ring constriction with application of amnioinfusion

作者：Tokunaka Mayumi; Hasegawa Junichi^*; Nakamura Masamitsu; Hamada Shoko; Matsuoka Ryu; Ichizuka Kiyotake; Sekizawa Akihiko; Okai Takashi

来源：Journal of Medical Ultrasonics, 2013, 40(3): 257-260.

DOI：10.1007/s10396-013-0451-6

• Umbilical ring constriction
• Amnioinfusion
• Fetal growth restriction
• Oligohydramnios
• Hyper-coiled cord

This is a case report of a pregnant 38-year-old primigravida woman. Due to severe fetal growth restriction and oligohydramnios, she was referred to our tertiary perinatal center at 24 weeks%26apos; gestation. To rule out chromosomal abnormalities and facilitate ultrasound evaluation of fetal morphology, we performed amniocentesis and subsequent amnioinfusion. Thereafter, a precise ultrasound examination revealed no obvious fetal morphological abnormalities except for a hyper-coiled cord and marginal placenta previa. During expectant management, the amount of amniotic fluid was maintained at 20-26 mm for a few days; however, the pregnancy resulted in intrauterine fetal death after 26 weeks + 5 days of gestation. The stillborn infant weighed 530 g (-3.3 SD) and had no obvious external abnormalities apart from umbilical ring constriction. Although a postmortem autopsy was not performed, it is suspected that the fetal growth restriction and the intrauterine fetal death were associated with the hyper-coiled cord and the umbilical ring constriction. It is thought that umbilical ring constriction might therefore be an irreversible fatal condition in cases with a hyper-coiled cord.

• 出版日期2013-7