Umbilical Vascular Thrombosis in Parturients:A Clinical Analysis of Six Cases

ZHANG Huan-qin; YANG Wei-hua; GUO Yao-shan; LIANG Xiao-ju

doi:10.12280/gjfckx.20250598

Abstract：Objective:To analyze the clinical profiles of parturients with umbilical vascular thrombosis,to delineate early recognition markers and diagnostic-therapeutic protocols,and to provide evidence for optimizing maternal-fetal outcome.Methods:Clinical data of 6 parturients with umbilical vascular thrombosis managed at Shenzhen Guangming District People's Hospital were retrospectively reviewed.Results:Among the 6 cases,5 cases exhibited abnormal antepartum cardiotocography(CTG).Prenatal ultrasound identified umbilical vascular thrombosis in 3 cases,all delivered by emergency cesarean section promoted by pathological CTG patterns.Within this subgroup,one fetus presented with a secondary single umbilical artery and one with markedly tight umbilical cord spirals;the latter received a complete course of antenatal corticosteroids for fetal pulmonary maturation after sonographic detection of umbilical arterial thrombosis at 31+1 weeks,followed by emergency cesarean section at 34+4 weeks.In the remaining 3 cases,prenatal ultrasound revealed no umbilical vascular anomaly;2 cases underwent emergency cesarean section for abnormal CTG and one had an elective cesarean section.All 6 neonates survived.Of the 5 parturient-neonate pairs screened for protein S and protein C activity,4 mothers were deficient in protein S and 2 in protein C;3 neonates were deficient in protein S and 5 in protein C.Conclusions:Whenever obstetric ultrasound indicates an altered umbilical vessel count,hyper-coiled umbilical cord,laboratory evidence of protein S or protein C deficiency,or abnormal CTG patterns,umbilical vascular thrombosis should be suspected.In preterm pregnancies with stable fetal status,expectant management under intensive surveillance may be considered.