Gambhir Prakash S, Gupte Sanjay, Kamat Amit D, Patankar Amit, Kulkarni Vinayak D, Phadke Mrudula A
Maharashtra University of Health Sciences, Yashokamal, Erandavane, Pune-411004, India.
Pediatr Dev Pathol. 2011 May-Jun;14(3):252-4. doi: 10.2350/10-06-0846-CR.1. Epub 2010 Nov 24.
Entanglement of the umbilical cord with fetal body parts is known to occur in early pregnancy. This can potentially compromise the cord blood flow and cause fetal demise. We report 3 instances of intrauterine fetal deaths in the 2nd trimester of pregnancy with longstanding cord entanglement. The cord had left impressions of entanglement on the entrapped growing fetal part. Restricted movements of the fetus due to cord entanglement led to reduced spiraling of the umbilical cord. Our case series demonstrates that tight entanglement of fetal body parts by the umbilical cord can cause fetal demise in the 2nd trimester. This event is associated with a straight umbilical cord. Thus, the presence of reduced spiraling in intrauterine fetal demise warrants a search for possible cord entanglement along with established causes, such as chromosomal and congenital anomalies.
已知在妊娠早期会发生脐带与胎儿身体部位的缠绕。这可能会损害脐带血流并导致胎儿死亡。我们报告了3例妊娠中期因长期脐带缠绕导致的宫内胎儿死亡病例。脐带在被缠绕的胎儿生长部位留下了缠绕的痕迹。由于脐带缠绕导致胎儿活动受限,从而使脐带的螺旋减少。我们的病例系列表明,脐带紧密缠绕胎儿身体部位可导致妊娠中期胎儿死亡。这一事件与脐带笔直有关。因此,在宫内胎儿死亡时出现螺旋减少的情况,除了寻找既定原因,如染色体和先天性异常外,还应寻找可能的脐带缠绕。