Perinatology.  2019 Sep;30(3):183-185. 10.14734/PN.2019.30.3.183.

Pseudo-Single Umbilical Artery by Spontaneous Intrauterine Umbilical Artery Thrombosis

• Baik M
• Im SY
• Lee G

• KMID: 2460034
• DOI: http://doi.org/10.14734/PN.2019.30.3.183

Abstract

Umbilical artery thrombosis is rare event and few prenatally diagnosed cases have been reported. Antenatal diagnosis is very critical, as it is associated with high risk of perinatal motility and morbidity such as intrauterine growth restriction and intrauterine fetal death. This study presents a rare case of intrauterine umbilical artery thrombosis, diagnosed by ultrasonography, at 32 weeks and 5 days of gestation in a 34-year-old woman who had an uneventful pregnancy. Early diagnosis with color Doppler ultrasonography is critical for pregnancy outcomes when fetal movement has diminished or intrauterine growth restriction is diagnosed, even though two umbilical artery already been confirmed on the first or the second-trimester ultrasonography scans.

Keyword

Umbilical artery; Thrombosis; Prenatal diagnosis; Ultrasonography; Doppler

MeSH Terms

Adult
Early Diagnosis
Female
Fetal Death
Fetal Movement
Humans
Pregnancy
Pregnancy Outcome
Prenatal Diagnosis
Thrombosis*
Ultrasonography
Ultrasonography, Doppler, Color
Umbilical Arteries*

Figure

• 

  Fig. 1 (A) There was single paravesical color Doppler flow in the left umbilical artery (arrow). (B)Fetal heart rate monitoring showed “saw-tooth pattern” with bradycardia.

• 

  Fig. 2 (A) Three vessels were noted with thromboic occlusion of one of umbilical arteries (arrow; H&E, ×12). (B) The placenta microscopically presented necrotic and avasular villi (arrowheads) embedded in large fibrinoid (arrow), and the collapsed intervillous space (circle) which consistent with early ischemic change (H&E, ×40).

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