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与分叉脐带插入相关的宫内胎儿死亡病例:文献综述及专业责任考虑。

A case of intrauterine fetal death related to furcate cord insertion: a brief review of the literature and professional liability considerations.

机构信息

Unit of Legal Medicine and Forensic Science, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.

Forensic Medicine of Canton Ticino, Ticino, Switzerland.

出版信息

Int J Legal Med. 2023 Jul;137(4):1093-1096. doi: 10.1007/s00414-023-02984-5. Epub 2023 Mar 20.

Abstract

The furcate insertion of the umbilical cord is an uncommon abnormality, often asymptomatic, potentially dangerous, or lethal for the fetus and the mother. This report shows the case of a healthy 29-year-old patient, at 37 weeks of gestation, admitted to the hospital two days before the due date because of the appearance of uterine contractions; clinical exams were regular. The following day, no fetal movements were perceived, a cardiotocography was performed, showing the absence of fetal heartbeat. A dead fetus was delivered. Autopsy showed furcate insertion of the umbilical cord and the rupture of the umbilical vessel, which caused fetal hemorrhagic shock. Furcate insertion still remains mostly undiagnosed and rarely it can be identified prenatally (only three cases are reported in literature). Future research, mainly in forensic fields, could improve the knowledge about this condition, helping prenatal diagnosis and providing warnings that can prevent similar deaths in the future.

摘要

脐带分叉插入是一种不常见的异常情况,通常无症状,但对胎儿和母亲具有潜在的危险或致命性。本报告介绍了一例健康的 29 岁患者,妊娠 37 周,因宫缩提前两天入院;临床检查正常。次日,未感觉到胎儿活动,行胎心监护,显示无胎心。分娩出死胎。尸检显示脐带分叉插入和脐血管破裂,导致胎儿出血性休克。脐带分叉插入仍然大多未被诊断,很少能在产前识别(文献中仅报道了三例)。未来的研究,主要在法医学领域,可能会提高对这种情况的认识,有助于产前诊断,并提供警告,以防止未来发生类似的死亡。

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