Spontaneous Umbilical Cord Hematoma

Pratichhya Khatiwada,Mohammed Alsabri,Viswanathan Kusum,Vohra Kiran,Salome Wiredu

doi:10.7759/cureus.13048

Abstract

Spontaneous umbilical cord hematoma is a rare complication with a usually benign course but is potentially fatal without vigilant and timely medical intervention.We present the case of a 23-year-old primigravida mother who presented in labor. She was placed on continuous fetal heart rate monitoring, which showed two episodes of fetal heart rate tracing of the category II variety. The labor was induced with oxytocin, and the ammonitic membrane was incised artificially. The baby was male, term at 38 weeks, with an appropriate weight, length, and head circumference. There was no gross anomaly or dysmorphic features; the APGAR (Appearance, Pulse, Grimace, Activity, and Respiration) score of the baby was 9 and 9 at the first and fifth minutes, respectively. A 4.5 cm hematoma was discovered on the umbilical cord immediately following delivery. He was admitted to the regular nursery for routine newborn care and was discharged home in stable condition. Spontaneous umbilical cord hematoma is usually due to the rupture of the umbilical vein. Mostly, the umbilical cord hematoma occurs spontaneously and often follows a benign course, however, in some cases, the perinatal loss secondary to umbilical cord hematoma could very high, especially if associated with abnormal fetal heart rate tracing. Because of the potential for fatality inherent in this condition and to understand the clinical manifestations, risk factors, and eventual course of spontaneous cord hematoma, we present this case to help fellow pediatricians reduce morbidity and mortality associated with it.

Highlights

Umbilical cord hematoma is defined as the extravasation of blood, mainly venous, in the Warton's jelly that covers the umbilical vessels [1]
Because of the potential for fatality inherent in this condition and to understand the clinical manifestations, risk factors, and eventual course of spontaneous cord hematoma, we present this case to help fellow pediatricians reduce morbidity and mortality associated with it
The perinatal loss for umbilical cord hematoma could be as high as 50% [3,4]

Summary

Introduction

Umbilical cord hematoma is defined as the extravasation of blood, mainly venous, in the Warton's jelly that covers the umbilical vessels [1]. Our patient is a 23-year-old primigravida mother who presented to the labor and delivery department with abdominal pain She had a history of cervical insufficiency with cervical cerclage placed in the third trimester and was taking daily progesterone. There was no active bleeding, hematoma, or bruise from any other side He was admitted to a regular nursery for routine newborn care. He was fed breast milk and was vitally stable with no concern of bleeding from the umbilical hematoma. At the office of the primary medical doctor, the complete blood count and bilirubin level were repeated and the labs were insignificant, the umbilical cord was dry, and there was no evidence of hematoma

Discussion

Conclusions

Disclosures