Hemorrhage from Umbilical Cord Ulceration Identified on Real-Time Ultrasound in a Fetus with Duodenal Atresia

Curtin, William M.; Maines, Jaimie L.; DeAngelis, Christina T.; Condon, Niamh; Ural, Serdar H.; Millington, Karmaine A.

doi:10.1155/2019/2680170

Cited by 3 publications

(2 citation statements)

References 11 publications

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“… 242 Spontaneous hemorrhage from the umbilical cord has been attributed to umbilical cord ulceration [associated with congenital upper intestinal (either duodenal or jejunal) atresia]. 243 The above notwithstanding a massive umbilical hematoma may occur without adverse sequelae. 238 …”

Section: Hematomamentioning

confidence: 99%

Current Perspectives of Prenatal Sonography of Umbilical Cord Morphology

Sherer¹,

Al-Haddad²,

Cheng³

et al. 2021

IJWH

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The umbilical cord constitutes a continuation of the fetal cardiovascular system anatomically bridging between the placenta and the fetus. This structure, critical in human development, enables mobility of the developing fetus within the gestational sac in contrast to the placenta, which is anchored to the uterine wall. The umbilical cord is protected by unique, robust anatomical features, which include: length of the umbilical cord, Wharton's jelly, two umbilical arteries, coiling, and suspension in amniotic fluid. These features all contribute to protect and buffer this essential structure from potential detrimental twisting, shearing, torsion, and compression forces throughout gestation, and specifically during labor and delivery. The arterial components of the umbilical cord are further protected by the presence of Hyrtl's anastomosis between the two respective umbilical arteries. Abnormalities of the umbilical cord are uncommon yet include excessively long or short cords, hyper or hypocoiling, cysts, single umbilical artery, supernumerary vessels, rarely an absent umbilical cord, stricture, furcate and velamentous insertions (including vasa previa), umbilical vein and arterial thrombosis, umbilical artery aneurysm, hematomas, and tumors (including hemangioma angiomyxoma and teratoma). This commentary will address current perspectives of prenatal sonography of the umbilical cord, including structural anomalies and the potential impact of future imaging technologies.

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Section: Hematomamentioning

confidence: 99%

Current Perspectives of Prenatal Sonography of Umbilical Cord Morphology

Sherer¹,

Al-Haddad²,

Cheng³

et al. 2021

IJWH

View full text Add to dashboard Cite

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“…In another report, a case of spontaneous hemorrhage from the umbilical cord was noted at the time of ultrasonography in a 33-week-old fetus with suspected duodenal atresia, in which immediate delivery resulted in a good outcome. 10) Although it may be difficult to identify an umbilical cord ulcer and hemorrhage on ultrasonography, it can be used as a diagnostic aid when these conditions are suspected.…”

Section: Discussionmentioning

confidence: 99%

A case of umbilical cord hemorrhagic ulceration with congenital upper gastrointestinal atresia

Fujimori

Owaki

Watanabe

et al. 2023

Hypertens Res Pregnancy

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A 23-year-old woman (gravida 3, para 2) was referred to our hospital at 29 weeks of gestation by a nearby doctor due to hydramnios and suspected umbilical cord hernia. Ultrasound and magnetic resonance imaging indicated hydramnios, umbilical cord hernia, and a dilated stomach, with suspicion of upper gastrointestinal atresia. She was hospitalized at 33 weeks of gestation owing to membrane rupture. Fetal bradycardia was observed during delivery, and an emergency cesarean section was performed. A female infant weighing 1,799 g was delivered (Apgar score: 1/ 1); hemorrhagic ulceration of the umbilical cord was observed. Pancreatic phospholipase A2, trypsin, lipase, and bile acid levels in the amniotic fluid were elevated. The infant died of hemorrhagic shock and circulatory failure on the second day after birth. Based on these findings, we hypothesize that umbilical cord ulceration or hemorrhage may occur in congenital upper gastrointestinal atresia due to discharge of fetal gastrointestinal enzymes into the amniotic fluid.

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