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Umbilical cord vascular thrombosis: literature review and two clinical cases

https://doi.org/10.17749/2313-7347/ob.gyn.rep.2021.260

Abstract

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. 

About the Authors

E. Iu. Iupatov
Kazan State Medical Academy – Branch of Russian Medical Academy of Continuing Professional Education, Health Ministry of Russian Federation; Kazan (Volga Region) Federal University
Russian Federation

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



T. E. Kurmanbaev
Kirov Military Medical Academy, Ministry of Defense of Russian Federation
Russian Federation

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

6 Klinicheskaya Str., Saint Petersburg 194044



I. R. Galimova
Kazan (Volga Region) Federal University
Russian Federation

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

18 Kremlevskaya Str., Kazan 420008



A. T. Khaertdinov
Kazan (Volga Region) Federal University
Russian Federation

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

18 Kremlevskaya Str., Kazan 420008



R. R. Mukhametova
Kazan (Volga Region) Federal University
Russian Federation

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

18 Kremlevskaya Str., Kazan 420008



A. L. Mirolyubov
Kazan (Volga Region) Federal University
Russian Federation

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

18 Kremlevskaya Str., Kazan 420008



D. N. Ablaeva
Kazan (Volga Region) Federal University
Russian Federation

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

18 Kremlevskaya Str., Kazan 420008



A. M. Khromova
Kazan State Medical Academy – Branch of Russian Medical Academy of Continuing Professional Education, Health Ministry of Russian Federation; Kazan (Volga Region) Federal University
Russian Federation

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

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



M. I. Timerzyanov
Kazan State Medical Academy – Branch of Russian Medical Academy of Continuing Professional Education, Health Ministry of Russian Federation; Kazan (Volga Region) Federal University
Russian Federation

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



M. D. Leonova
Maternity Hospital № 13
Russian Federation

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

4 Kostromskaya Str., Saint Petersburg 191124



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Review

For citations:


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. Umbilical cord vascular thrombosis: literature review and two clinical cases. Obstetrics, Gynecology and Reproduction. 2022;16(1):81-89. (In Russ.) https://doi.org/10.17749/2313-7347/ob.gyn.rep.2021.260

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ISSN 2313-7347 (Print)
ISSN 2500-3194 (Online)