Zhao Peng, Lu Yicheng, Liu Sitong, Zhang Lidan, Chen Chong, Yang Xiaofu
Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Ultrasonography, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Front Med (Lausanne). 2025 Mar 24;12:1540685. doi: 10.3389/fmed.2025.1540685. eCollection 2025.
Umbilical artery thrombosis (UAT) is a rare but serious pregnancy complication, potentially causing fetal growth restriction, distress, and stillbirth. Diagnosis relies on Doppler ultrasound and pathological assessment. Close monitoring and potential low-molecular-weight heparin (LMWH) therapy aim to prolong gestation and improve outcomes, but debate persists on its efficacy compared to expectant management.
A retrospective study, conducted between January 2013 and December 2023, enrolled singleton pregnant women diagnosed with UAT during pregnancy. The experiment group included pregnant women who underwent LMWH with anti-coagulation therapy during pregnancy, while the expectant group comprised pregnancies that received standard prenatal care without any specific intervention for UAT.
The expectant group showed a significant increase in birth weight (expectant vs. experiment: 2434.40 ± 770.20 g vs. 1874.46 ± 717.83 g, < 0.05) and a significant decrease in the incidence of births before 34 weeks (expectant vs. experiment: 42.24% vs. 82.75%, < 0.05). Gestational age at birth was notably higher in the expectant group as compared to the experiment group (35.32 ± 3.89 vs. 33.59 ± 4.17), although the difference did not reach statistical significance ( = 0.110). The multi-factor ANOVA revealed statistically significant effects of anti-coagulation therapy ( = 4.479, = 0.039) and gestational age at birth ( = 179.110, = 0.000) on birth weight. This study found that the relationship between these variables can be formulated as: birth weight = -3314.782-256.106 × anti-coagulation therapy (coded as 1 if yes and 0 if no) +161.858 × gestational age at birth.
Our study suggests that expectant therapy may offer substantial benefits compared to experimental therapy involving the administration of LMWH.
脐动脉血栓形成（UAT）是一种罕见但严重的妊娠并发症，可能导致胎儿生长受限、窘迫和死产。诊断依赖于多普勒超声和病理评估。密切监测和潜在的低分子量肝素（LMWH）治疗旨在延长孕周并改善结局，但与期待治疗相比，其疗效仍存在争议。
一项回顾性研究，在2013年1月至2023年12月期间进行，纳入孕期诊断为UAT的单胎孕妇。实验组包括孕期接受LMWH抗凝治疗的孕妇，而期待组包括接受标准产前护理且未对UAT进行任何特殊干预的孕妇。
期待组出生体重显著增加（期待组与实验组：2434.40±770.20g对1874.46±717.83g，<0.05），34周前出生的发生率显著降低（期待组与实验组：42.24%对82.75%，<0.05）。期待组出生时的孕周明显高于实验组（35.32±3.89对33.59±4.17），尽管差异未达到统计学意义（=0.110）。多因素方差分析显示抗凝治疗（=4.479，=0.039）和出生时的孕周（=179.110，=0.000）对出生体重有统计学显著影响。本研究发现这些变量之间的关系可以表示为：出生体重=-3314.782-256.106×抗凝治疗（是为1，否为0）+161.858×出生时的孕周。
我们的研究表明，与使用LMWH的实验性治疗相比，期待治疗可能带来更大的益处。
