Obstetrics and Gynecology, University of Michigan Health-West, Wyoming, Michigan, USA.
Obstetrics and Gynecology, University of Michigan Health-West, Wyoming, Michigan, USA
BMJ Case Rep. 2022 Feb 2;15(2):e246023. doi: 10.1136/bcr-2021-246023.
Nuchal cord accidents comprise a third of stillbirths in the third trimester. These are often due to higher order nuchal cords, with more than three loops. In this report, we discuss a case of a gestation complicated by a nuchal cord with eight loops and severe fetal growth restriction, requiring expedited delivery due to non-reassuring fetal heart tones. Our case demonstrates the value of high-quality ultrasound in detecting complex nuchal cords, as well as highlighting the potentially dynamic and unstable fetal status in an affected gestation. Antenatal knowledge of nuchal cord in the setting of non-reassuring fetal status can help guide patient counselling and assist with identifying possible aetiologies. Finally, our case demonstrates that close monitoring and early intervention can prevent potentially catastrophic outcomes.
脐带意外占妊娠晚期三分之一的死胎原因。这些通常是由于三圈以上的高级脐带绕颈。在本报告中，我们讨论了一个妊娠复杂化的病例，该病例的脐带绕颈有八圈，且胎儿生长受限严重，由于胎心监护不令人满意，需要紧急分娩。我们的病例表明了高质量超声在检测复杂脐带绕颈中的价值，同时也突出了受影响妊娠中胎儿状态的潜在动态和不稳定。在胎心监护不令人满意的情况下，对脐带绕颈的产前了解可以帮助指导患者咨询，并有助于确定可能的病因。最后，我们的病例表明，密切监测和早期干预可以预防潜在的灾难性后果。
