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Umbilical cord ulceration: An underdiagnosed entity.

Barkha Maheshwari1, Maitrayee Roy2, Shipra Agarwal2

  • 1Department of Pathology, Maulana Azad Medical College, New Delhi, India.

Obstetrics & Gynecology Science
|September 27, 2016
PubMed
Summary

Umbilical cord ulceration, a rare cause of fetal distress and intrauterine death, is often linked to intestinal atresia. Early recognition is crucial for improving fetal outcomes in this high-risk condition.

Keywords:
Intestinal atresiaIntrauterine hemorrhageUmbilical cord ulcerWhartson's jelly

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Area of Science:

  • Perinatology
  • Fetal Medicine
  • Obstetrics

Background:

  • Umbilical cord ulceration is a rare obstetric complication.
  • It is associated with significant fetal morbidity and mortality, often leading to intrauterine death.
  • A strong association with congenital intestinal atresia has been previously reported.

Observation:

  • This report details two cases of umbilical cord ulceration.
  • One case presented unusually early at 26 weeks gestation.
  • Typical presentations involve preterm labor or rupture of membranes after 30 weeks, followed by sudden fetal bradycardia.

Findings:

  • Umbilical cord ulceration can cause sudden fetal bradycardia due to fetal hemorrhage.
  • The condition is linked to a high rate of intrauterine fetal demise.
  • Early presentation at 26 weeks gestation is possible, deviating from the typical post-30 week presentation.

Implications:

  • Increased awareness of umbilical cord ulceration is essential for obstetric care providers.
  • Timely diagnosis and management are critical to mitigate high perinatal mortality and morbidity.
  • Improved fetal outcomes are achievable with prompt and appropriate interventions.