Umbilical cord stricture causing intrauterine fetal death in a 22-week fetus

Umbilical cord stricture is an uncommon but distinctive condition associated with intrauterine fetal death. Although cases have been reported periodically since the last century, there has been considerable speculation as to whether the condition is real or a postmortem artifact.

A 27-year-old woman, G2P0SA0AA1, was diagnosed with intrauterine fetal death at 22 weeks' gestation. The dead fetus with Apgar score 0'->0' was delivered. The cord was twisted at the insertion site of the umbilicus. Neither growth restriction nor anatomic abnormalities were noted.

Although the risk of recurrence has generally been thought to be low in the past, patients with a demise attributed to umbilical cord stricture should be counseled. The mechanism of cord stricture and how it leads to fetal death remain unknown. If the exact etiology of cord stricture can be determined, efforts may be directed at preventing a recurrence. Additional published cases may be helpful.