akusherstvoObstetrics, Gynecology and ReproductionАкушерство, Гинекология и Репродукция2313-73472500-3194IRBIS LLC10.17749/2313-7347/ob.gyn.rep.2021.260akusherstvo-1245Research ArticleCLINICAL CASEКЛИНИЧЕСКИЙ СЛУЧАЙUmbilical cord vascular thrombosis: literature review and two clinical casesТромбоз сосудов пуповины: обзор литературы и описание двух клинических наблюденийhttps://orcid.org/0000-0001-8945-8912ЮпатовЕ. Ю.IupatovE. Iu.

к.м.н., доцент, зав. кафедрой акушерства и гинекологии, 420015 Казань, ул. Бутлерова, д. 36;

доцент кафедры хирургии и последипломного образования Института фундаментальной медицины и биологии, 420008 Казань, Кремлёвская ул., д. 18

MD, PhD, Associate Professor, Head of the Department of Obstetrics and Gynecology, 36 Butlerova Str., Kazan 420015;

Associate Professor, Department of Surgery and Postgraduate Education, Institute of Fundamental Medicine and Biology, 18 Kremlevskaya Str., Kazan 420008

https://orcid.org/0000-0003-0644-5767КурманбаевТ. Е.KurmanbaevT. E.

к.м.н., преподаватель кафедры акушерства и гинекологии,

194044 Санкт-Петербург, ул. Клиническая, д. 6

MD, PhD, Faculty Member, Department of Obstetrics and Gynecology,

6 Klinicheskaya Str., Saint Petersburg 194044

timka_rus@inbox.ruhttps://orcid.org/0000-0002-1676-9696ГалимоваИ. Р.GalimovaI. R.

к.м.н., доцент, зам. главного врача по акушерско–гинекологической помощи медико-санитарной части,

420008 Казань, Кремлёвская ул., д. 18

MD, PhD, Associate Professor, Deputy Chief Physician for Obstetric and Gynecological Care, Medical and Sanitary Unit,

18 Kremlevskaya Str., Kazan 420008

https://orcid.org/0000-0001-9081-9623ХаертдиновА. Т.KhaertdinovA. T.

к.м.н., врач акушер-гинеколог, зав. родильным отделением медико-санитарной части,

420008 Казань, Кремлёвская ул., д. 18

MD, PhD, Obstetrician-Gynecologist, Head of the Maternity Department, Medical and Sanitary Unit,

18 Kremlevskaya Str., Kazan 420008

https://orcid.org/0000-0002-7599-7998МухаметоваР. Р.MukhametovaR. R.

 врач акушер-гинеколог акушерского отделения медико-санитарной части,

420008 Казань, Кремлёвская ул., д. 18

MD, Obstetrician-Gynecologist, Obstetric Department, Medical and Sanitary Unit,

18 Kremlevskaya Str., Kazan 420008

https://orcid.org/0000-0001-8155-9022МиролюбовА. Л.MirolyubovA. L.

к.м.н., врач акушер-гинеколог акушерского отделения медико-санитарной части,

420008 Казань, Кремлёвская ул., д. 18

MD, PhD, Obstetrician-Gynecologist, Obstetric Department, Medical and Sanitary Unit,

18 Kremlevskaya Str., Kazan 420008

https://orcid.org/0000-0003-1416-5618АблаеваД. Н.AblaevaD. N.

врач акушер-гинеколог акушерского отделения медико-санитарной части,

420008 Казань, Кремлёвская ул., д. 18

MD, Obstetrician-Gynecologist, Obstetric Department, Medical and Sanitary Unit,

18 Kremlevskaya Str., Kazan 420008

https://orcid.org/0000-0002-0239-0503ХромоваА. М.KhromovaA. M.

к.м.н., доцент кафедры судебной медицины, 420015 Казань, ул. Бутлерова, д. 36

доцент кафедры профилактической медицины Института фундаментальной медицины и биологии, 420008 Казань, Кремлёвская ул., д. 18

MD, PhD, Associate Professor, Department of Forensic Medicine, 36 Butlerova Str., Kazan 420015;

Associate Professor, Department of Preventive Medicine, 18 Kremlevskaya Str., Kazan 420008

https://orcid.org/0000-0003-3918-8832ТимерзяновМ. И.TimerzyanovM. I.

д.м.н., доцент, зав. кафедрой судебной медицины, 420015 Казань, ул. Бутлерова, д. 36;

зав. кафедрой профилактической медицины Института фундаментальной медицины и биологии, 420008 Казань, Кремлёвская ул., д. 18

MD, Dr Sci Med, Head of the Department of Forensic Medicine, 36 Butlerova Str., Kazan 420015;

Head of the Department of Preventive Medicine, 18 Kremlevskaya Str., Kazan 420008

https://orcid.org/0000-0002-3813-2995ЛеоноваМ. Д.LeonovaM. D.

врач акушер-гинеколог, зав. родильным отделением,

191124 Санкт-Петербург, ул. Костромская, д. 4

MD, Obstetrician-Gynecologist, Head of the Maternity Department,

4 Kostromskaya Str., Saint Petersburg 191124

Казанская государственная медицинская академия – филиал ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации; ФГАОУ ВО «Казанский (Приволжский) федеральный университет»РоссияKazan State Medical Academy – Branch of Russian Medical Academy of Continuing Professional Education, Health Ministry of Russian Federation; Kazan (Volga Region) Federal UniversityRussian FederationФГБВОУ ВО «Военно-медицинская академия имени С.М. Кирова» Министерства обороны Российской ФедерацииРоссияKirov Military Medical Academy, Ministry of Defense of Russian FederationRussian FederationФГАОУ ВО «Казанский (Приволжский) федеральный университет»РоссияKazan (Volga Region) Federal UniversityRussian FederationСПб ГБУЗ «Родильный дом № 13»РоссияMaternity Hospital № 13Russian Federation2022070320221618189Copyright © Iupatov E.I., Kurmanbaev T.E., Galimova I.R., Khaertdinov A.T., Mukhametova R.R., Mirolyubov A.L., Ablaeva D.N., Khromova A.M., Timerzyanov M.I., Leonova M.D., 20222022Юпатов Е.Ю., Курманбаев Т.Е., Галимова И.Р., Хаертдинов А.Т., Мухаметова Р.Р., Миролюбов А.Л., Аблаева Д.Н., Хромова А.М., Тимерзянов М.И., Леонова М.Д.Iupatov E.I., Kurmanbaev T.E., Galimova I.R., Khaertdinov A.T., Mukhametova R.R., Mirolyubov A.L., Ablaeva D.N., Khromova A.M., Timerzyanov M.I., Leonova M.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gynecology.su/jour/article/view/1245

Thrombosis of the umbilical cord vessels is a rare complication of pregnancy, combined with a high level of perinatal morbidity and mortality. Anomalies of vascular attachment (velamentous attachment), pathology of the umbilical cord (hyperspiralization, short or long umbilical cord), intrauterine infections, maternal diabetes mellitus and preeclampsia as well as meconium found in the amniotic fluid are among the risk factors of developing thrombosis in the umbilical cord vessels. Here we present two clinical observations of umbilical vein thrombosis at full-term pregnancy. In both cases, during pregnancy and childbirth, no signs of umbilical cord pathology were found according to cardiotocography and Doppler ultrasound; despite this, the children were born in hypoxic state. Both newborns were transferred to the second stage of treatment due to suspected intrauterine pneumonia. Velamentous attachment, intrauterine infections as well as meconium found in the amniotic fluid were the risk factors of developing umbilical vein thrombosis described in case 1 and case 2, respectively. During pregnancy, both female patients suffered from clinically confirmed novel coronavirus infection (COVID-19) and contacted patients with COVID-19 in the third trimester of gestation. It is likely that endothelial damage caused by the novel coronavirus SARS-CoV-2 was one of the risk factors for the development of umbilical vein thrombosis, but this issue requires to be further explored. 

Тромбоз сосудов пуповины – редкое осложнение беременности, сочетающееся с высоким уровнем перинатальной заболеваемости и смертности. Среди факторов риска развития тромбоза сосудов пуповины выделяют аномалии прикрепления сосудов (оболочечное прикрепление), патологию пуповины (гиперспирализация, короткая или длинная пуповина), внутриутробные инфекции, сахарный диабет и преэклампсия у матери, а также наличие мекония в околоплодных водах. Приводим 2 клинических наблюдения тромбоза пупочной вены на доношенном сроке беременности. По данным кардиотокографии и доплерометрии, в обоих случаях во время беременности и родов отсутствовали признаки патологии пуповины; несмотря на это, дети родились в состоянии гипоксии. Оба новорожденных переведены на второй этап лечения в связи с подозрением на внутриутробную пневмонию. Из факторов риска тромбоза сосудов пуповины в приведенных примерах можно выделить оболочечное прикрепление сосудов пуповины, внутриутробные инфекции, во втором случае – наличие мекония в околоплодных водах. Обе пациентки во время беременности перенесли клинически подтвержденную новую коронавирусную инфекцию (COVID-19), а также находились в контакте с пациентами, больными COVID-19, в III триместре гестации. Вероятно, повреждение эндотелия, вызванное новым коронавирусом SARS-CoV-2, явилось одним из дополнительных факторов риска развития тромбоза пупочной вены, однако данный вопрос требует дальнейшего исследования. 

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The authors declare that there are no conflicts of interest present.