Objective To analyze prenatal ultrasound features and pregnancy outcomes of umbilical artery occlusion combined with excessive twisting of the umbilical cord.Methods A total of 6 cases diagnosed as umbilical artery occlusion combined with excessive twisting of the umbilical cord were collected.The prenatal ultrasound features,pregnancy outcomes and data of umbilical cord pathological examination were analyzed.Results Prenatal ultrasound features:all 6 fetuses originally had two normal umbilical arteries,and then one umbilical artery became occluded and the umbilical cord was excessively torsioned.Before the occlusion of the umbilical artery,the gestational age of the fetuses on ultrasound was accordance with the clinical gestational age,but after occlusion,the ultrasound gestational age of 3 cases was smaller than the clinical gestational age.5 cases had thickened placentas,and 1 case had polyhydramnios.The pulsatility index of the middle cerebral artery(MCA-PI)and pulsatility index of umbilical artery(UA-PI)of the 6 fetuses were lower than the normal reference values,while the ratio of peak systolic velocity to end-diastolic velocity of the umbilical artery(UA-S/D)showed no abnormalities.Pregnancy outcomes:among the 6 fetuses,there was 1 intrauterine fetal death and 5 live births.All 5 live births were delivered by cesarean section due to abnormal fetal heart monitoring.Among the 5 liveborn infants,3 were premature,4 had low birth weight,and 2 were small for gestational age.Umbilical cord pathological examination:all fetuses had excessively twisted umbilical cords with umbilical artery thrombosis.The umbilical cord of the stillborn fetus became narrowed and showed cord-like necrotic changes.Conclusion When umbilical artery occlusion is combined with excessive twisting of the umbilical cord,prenatal ultrasound often shows a decreased significant MCA-PI of the fetus.With active intervention based on the manifestations of fetal heart rate monitoring,the occurrence of adverse pregnancy outcomes can be avoided.
关键词
超声检查,产前/脐动脉闭塞/脐带过度扭转/妊娠结局/胎儿
Key words
Ultrasonography,prenatal/Umbilical artery occlusion/Excessive twisting of the umbilical cord/Pregnancy outcome/Fetus
维普
万方数据