Klinischer Fallbericht: Intrauterine Diagnose einer Thrombose der Arteria umbilicalis

Abstract

Objective: In this case report we describe the prenatal diagnosis of a thrombosis of one umbilical artery with reverse flow in this artery and shunting. The postnatal diagnostics and procedure is also described. Results: A 28-year old primipara was sent to our hospital because of non-assuring CTG waveforms in the office of a gynaecologist. Using colour Doppler we diagnosed a thrombosis of one umbilical artery and reverse flow in this artery with shunting from the non-occluded artery into the occluded one. Because of pathological CTG waveforms and the known thrombosis, the baby was delivered. Postnatally we found in addition a complete thrombosis of the abdominal aorta from below the renal arteries and a complete thrombosis of both iliac arteries. The legs were perfused retrogradely by the open umbilical arteries and anastomosis from these arteries to the arteries of the legs. Histopathologically we found a thrombosis of the placental vessels (End-angiopathia obliterans). Conclusion: Thrombosis of fetal vessels may occur even in non-risk-pregnancies. First sign might be an unusual CTG, whereas colour-Doppler may be helpful in diagnosis.