Department of Obstetrics, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Zentrum für Pränataldiagnostik und Humangenetik, Berlin, Germany.
J Perinat Med. 2020 Oct 25;48(8):819-824. doi: 10.1515/jpm-2019-0459.
Objectives Furcate cord insertion is a rare abnormality affecting approximately 0.1% of all pregnancies. Macroscopically, the umbilical vessels separate before reaching the placenta, lose their Wharton's jelly, and insert at the placenta centrally, eccentrically, or marginally. The aim of this retrospective study was to determine the prevalence of furcate cord insertion more accurately, the pathological characteristics, and clinical outcomes. Methods We conducted a retrospective study of 132 cases of furcate insertion of the umbilical cord using the pathological database of the Charité University Hospital Berlin, Germany, between 1993 and 2016. This included 99 cases, including one termination of pregnancy within our institution and 33 cases from external hospitals. An analysis of the pathological features of the 132 cases and the perinatal outcome of the 98 cases within our institution were performed. Results Furcate cord insertion occurred in 0.16% pregnancies. Of the 132 cases, seven cases of intrauterine fetal deaths were observed. Three of those could be linked to the furcate cord insertion. In two of those cases, single umbilical vessel rupture was identified as the cause of fetal death. Conclusions In most cases of furcate cord insertion, the outcome is good; however, intrauterine fetal death occurs in approximately 1.02% of cases.
目的 分叉脐带插入是一种罕见的异常情况，影响约 0.1%的所有妊娠。宏观上，脐带血管在到达胎盘之前分离，失去 Wharton 胶，在胎盘中央、偏心或边缘插入。本回顾性研究的目的是更准确地确定分叉脐带插入的发生率、病理特征和临床结局。
方法 我们对 1993 年至 2016 年间德国柏林夏洛蒂大学医院的病理数据库中 132 例分叉脐带插入病例进行了回顾性研究，其中包括 99 例我院内终止妊娠和 33 例外院病例。对 132 例的病理特征和 98 例我院内围产结局进行了分析。
结果 分叉脐带插入在 0.16%的妊娠中发生。在 132 例中，观察到 7 例宫内胎儿死亡。其中 3 例可归因于分叉脐带插入。在这 3 例中，有 2 例是由于单脐动脉破裂导致胎儿死亡。
结论 在大多数分叉脐带插入病例中，结局良好；然而，约 1.02%的病例会发生宫内胎儿死亡。
