Umbilical cord ulceration: An underdiagnosed entity

Abstract

Umbilical cord ulceration is a rare condition presenting with sudden fetal bradycardia due to fetal hemorrhage and in most cases leading to intrauterine death. A strong association with intestinal atresia has been reported. Most cases present after 30 weeks of gestation, with preterm labor or rupture of membranes followed by sudden fetal bradycardia. We report two such cases of umbilical cord ulceration and review the available literature. One of the cases interestingly presented at 26 weeks, much earlier than what is reported in the world literature. In view of high perinatal mortality and morbidity, awareness of this condition is mandatory for timely and appropriate management to improve the fetal outcome.

Extra abdominal Umbilical Vein Varix Causing Stillbirth: a Case Report

“…[10] Other related causes of umbilical cord ulceration include smoking, patent omphalomesenteric duct, absence of Wharton's jelly and injury by fetal nail. [13] Conclusion Extra-abdominal intra-amniotic umbilical vein varix is an uncommon anomaly. There are numerous reports in the literature about intra-abdominal vein varix which can be easily detected by ultrasound examination.…”

“…These include vascular theory, reflux theory, and epithelial abnormality. [13] The first theory is related to vascular changes and ischemic changes which will lead to surface ulceration. The second theory is related to chemical material reflux like gastric and intestinal digestive enzymes effects.…”

“…[5] These might lead to serious complications like arterial or venous thrombosis, hematoma and ulceration. [5,12,13] Ulceration of the umbilical cord is one of the complications that can result in alteration of fetal heart rate. Many theories had been developed to explain the cases of umbilical cord ulceration.…”