Towers C V, Juratsch C E, Garite T J
Long Beach Memorial Women's Hospital, Long Beach, California 92615, USA.
J Perinatol. 2009 Jul;29(7):517-20. doi: 10.1038/jp.2008.247.
The objective of this study is to present and describe the fetal heart rate appearance in pregnancies complicated by an antenatal spontaneous umbilical cord hematoma that resulted in a live birth. Three cases of antenatal spontaneous umbilical cord hematoma are described. All three patients presented with a complaint of decreased fetal movement. The fetal heart monitor tracings on admission are depicted and discussed. In all three cases, the fetal heart rate pattern showed decreased variability with an absence of accelerations. Decelerations were noted but were identified in 25% or less of the contractions and primarily with contractions that exceeded 90 s. Absent accelerations with minimal to absent variability, if caused by uteroplacental insufficiency, usually develop in the presence of recurrent decelerations. Absent accelerations with minimal to absent variability in the absence of recurrent decelerations may suggest other causes including aneuploidy or congenital cardiac or neurologic anomalies. Though rare, spontaneous umbilical cord hematoma can be added to the differential.
本研究的目的是呈现并描述因产前自发性脐带血肿导致活产的妊娠中的胎儿心率表现。描述了3例产前自发性脐带血肿病例。所有3例患者均主诉胎动减少。描绘并讨论了入院时的胎儿心率监测图。在所有3例病例中，胎儿心率模式均显示变异性降低且无加速。观察到有减速，但仅在25%或更少的宫缩中出现，且主要出现在持续时间超过90秒的宫缩中。如果由子宫胎盘功能不全引起，无加速且变异性极小或无变异性通常在反复出现减速的情况下出现。在无反复减速的情况下无加速且变异性极小或无变异性可能提示其他原因，包括非整倍体或先天性心脏或神经异常。虽然罕见，但自发性脐带血肿也可列入鉴别诊断范围。
