Abstract
Abstract Objectives Umbilical artery thrombosis is a significant umbilical cord condition that is associated with adverse pregnancy outcomes. However, no consensus has been reached regarding how umbilical artery thrombosis should be diagnosed or managed because of its rarity and the difficulty associated with an antenatal diagnosis. Case presentation Here, we describe a case involving decreased fetal movement and non-reassuring fetal status (NRFS) in which acute umbilical artery thrombosis was prenatally diagnosed. Transabdominal ultrasound showed that the cross-section of the umbilical cord had one normal artery and a small deformed echogenic area. A characteristic ultrasound finding known as the “wink sign” contributed to the prenatal diagnosis. Conclusions Evaluation of the umbilical cord enabled the estimation and facilitated the subsequent antenatal management.
Highlights
Case presentation: Here, we describe a case involving decreased fetal movement and non-reassuring fetal status (NRFS) in which acute umbilical artery thrombosis was prenatally diagnosed
We described a case with decreased fetal movement and NRFS because of acute thrombosis of umbilical artery, diagnosed using ultrasound evaluation of the crosssectional surface of the umbilical cord prior to caesarean delivery
The evaluation of a cross-sectional surface of the umbilical free loop and the bilateral umbilical artery beside the fetal bladder is supportive of a diagnosis of umbilical artery thrombosis
Summary
A 29-year-old nulliparous woman at 33+4 weeks of gestation was referred to our hospital because of sudden decreased fetal movement and abnormal fetal heart rate (FHR) patterns. She had achieved spontaneous pregnancy, and there was no fetal or placental abnormality diagnosed at her prior clinic. Placental, cord insertion abnormalities, or cord entanglement was detected using an ultrasound. On the following day (at 33 + 5 weeks), transabdominal ultrasound examination revealed the absence of blood flow of the unilateral umbilical artery of the free loop. Left umbilical artery beside the fetal bladder could not be detected using color Doppler of ultrasound. The ultrasound examinations were performed using a Voluson E8 GE ultrasound machine with an RM6C transducer (GE Health care, Japan)
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