Chen Ruiyun, Lin Lin
Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China.
Am J Perinatol. 2025 Apr;42(5):586-592. doi: 10.1055/a-2412-3169. Epub 2024 Oct 1.
Umbilical cord vascular rupture is a rare and severe condition that can occur during labor, leading to adverse outcomes for the fetus before as well as after delivery. Prompt diagnosis and intervention are crucial for improving the chances of a successful outcome. We aimed to analyze cases of umbilical cord vascular rupture during labor to provide insights into this challenging condition.This retrospective study evaluated the medical records of patients diagnosed with umbilical cord vessel rupture or umbilical cord hematoma at Fujian Maternity and Child Health Hospital from January 1, 2015, to May 31, 2023. The inclusion criteria included gestational age of ≥28 weeks, occurrence during labor, and availability of complete delivery data. Data on fetal heart rate (FHR) changes, delivery intervals, intraoperative findings, placental pathology, and neonatal outcomes were collected and analyzed.A total of 12 cases were analyzed. The incidence of umbilical cord vascular rupture during childbirth was 0.08%. The FHR patterns in umbilical cord rupture during delivery included baseline tachycardia, minimal or absent variability, variable or late deceleration, prolonged deceleration, and undetectable heart rate. The bradycardia-to-delivery interval (BDI) ranged from 6 to 26 minutes. Among the 12 neonates, 9 were discharged well, 2 were stillbirths, and there was 1 neonatal death. Hemorrhagic shock was common in live births.Our study highlights the significance of continuous FHR monitoring during labor and the urgent need for medical teams to respond quickly in cases of umbilical cord vascular rupture. Despite advancements in neonatal resuscitation techniques, managing cases with undetectable fetal heart activity remains clinically challenging, and even with immediate pregnancy termination, poor neonatal outcomes may still occur. · Umbilical cord vascular rupture during labor is a rare event.. · Its clinical management presents significant challenges.. · Advances in neonatal resuscitation have improved rescue success rates.. · In such cases, hemorrhagic shock is common in live births..
脐带血管破裂是一种罕见且严重的情况，可发生在分娩期间，导致胎儿在分娩前后出现不良结局。及时诊断和干预对于提高成功结局的几率至关重要。我们旨在分析分娩期间脐带血管破裂的病例，以深入了解这一具有挑战性的情况。这项回顾性研究评估了2015年1月1日至2023年5月31日在福建省妇幼保健院被诊断为脐带血管破裂或脐带血肿的患者的病历。纳入标准包括孕周≥28周、分娩期间发生以及有完整的分娩数据。收集并分析了胎儿心率（FHR）变化、分娩间隔、术中发现、胎盘病理和新生儿结局的数据。共分析了12例病例。分娩期间脐带血管破裂的发生率为0.08%。分娩期间脐带破裂时的FHR模式包括基线心动过速、最小或无变异性、可变或晚期减速、延长减速以及无法检测到心率。心动过缓至分娩间隔（BDI）为6至26分钟。在这12例新生儿中，9例顺利出院，2例死产，1例新生儿死亡。失血性休克在活产中很常见。我们的研究强调了分娩期间持续进行FHR监测的重要性，以及医疗团队在脐带血管破裂病例中迅速做出反应的迫切需求。尽管新生儿复苏技术有所进步，但处理胎儿心脏活动无法检测到的病例在临床上仍然具有挑战性，即使立即终止妊娠，仍可能出现不良新生儿结局。·分娩期间脐带血管破裂是一种罕见事件。·其临床管理面临重大挑战。·新生儿复苏的进展提高了抢救成功率。·在这种情况下，失血性休克在活产中很常见。
