Kurakazu Mariko, Kurakazu Masamitsu, Murata Masaharu, Miyamoto Tatsuki, Takahashi Yoko, Hamasaki Makoto, Ohta Eiji, Yotsumoto Fusanori, Miyamoto Shingo
Department of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
Center for Maternal, Fetal and Neonatal Medicine, Fukuoka University Hospital, Fukuoka, Japan.
J Med Case Rep. 2019 May 18;13(1):149. doi: 10.1186/s13256-019-2094-8.
Abnormalities in the number of vessels can be found for both the umbilical artery and vein. We sometimes encounter cases of a decreased number of umbilical cord vessels, such as a single umbilical artery. In contrast, there may be an increase from three to four vessels within the umbilical cord. A supernumerary umbilical vein is particularly very rare, and it is generally found in combination with congenital anomalies. We report a case of a partial supernumerary umbilical vein.
The previous pregnancy of a 37-year-old healthy Japanese woman (gravida 2, para 1) had been uncomplicated, and the resulting child was alive and well. Prenatal examination at 36 weeks of gestation revealed the coexistence of a four-vessel part and a normal three-vessel part of the umbilical cord. A healthy female neonate weighing 2726 g was born at 38 weeks of gestation. The umbilical cord measured 40 cm in length; the four-vessel part continued to a distance of 18 cm from the surface of the infant's body, and the remaining umbilical cord comprised three vessels. On histological examination, the fetal side of the umbilical cord had two arteries and two veins, and the placental side had two arteries and one vein. Isolated supernumerary umbilical veins tend to be overlooked. We consider that it is important to evaluate the number of umbilical cord vessels in the second trimester using ultrasound combined with color Doppler in at least three sites: the insertion sites on both the fetal abdomen and placenta, and the free loop of the umbilical cord.
Prenatal diagnosis of isolated supernumerary umbilical cord vessels tends to be overlooked. However, supernumerary vessels of the umbilical can be associated with fetal congenital anomalies. The number of vessels within the umbilical cord must be examined because the detection of such abnormalities may lead to the prenatal diagnosis of other congenital anomalies.
脐动脉和脐静脉均可出现血管数量异常。我们有时会遇到脐带血管数量减少的情况，比如单脐动脉。相反，脐带内血管数量也可能从三条增加到四条。额外的脐静脉极为罕见，通常与先天性畸形并存。我们报告一例部分额外脐静脉的病例。
一名37岁健康日本女性（孕2产1），前次妊娠无并发症，所产婴儿健康存活。妊娠36周时的产前检查发现脐带存在四血管部分和正常的三血管部分。妊娠38周时娩出一名体重2726g的健康女婴。脐带长度为40cm；四血管部分从婴儿体表延伸18cm，其余脐带为三条血管。组织学检查显示，脐带胎儿侧有两条动脉和两条静脉，胎盘侧有两条动脉和一条静脉。孤立的额外脐静脉容易被忽视。我们认为，在孕中期使用超声联合彩色多普勒至少在三个部位评估脐带血管数量很重要：胎儿腹部和胎盘的附着部位以及脐带的游离袢。
孤立的额外脐带血管的产前诊断往往被忽视。然而，脐带的额外血管可能与胎儿先天性畸形有关。必须检查脐带内的血管数量，因为发现此类异常可能有助于产前诊断其他先天性畸形。
