A case of fetal anemia caused by rupture of umbilical cord blood vessels with mangrove-like velamentous cord insertion

KAMIYA Akiko, KIM Mirang, TANAKA Eriko, KIDO Erina, NAKAE Aya, KAKUBARI Reisa, MIYOSHI Yukari, AMEMIYA Kyoka

doi:10.11437/sanpunosinpo.75.301

The prognosis for neonates with velamentous cord insertion is poor because the umbilical cord is easily compressed and umbilical blood vessels can be torn off with rupture of the membranes or fetal movement. We experienced a case of velamentous cord insertion in which an emergency cesarean section was performed while the membrane was not ruptured and the umbilical cord vessels were ruptured. The patient was a 28-year-old woman, gravida two, para one. There were no abnormalities during the pregnancy. At 40 weeks of gestation, NST showed a baseline heart rate of 180 beats/min, loss of heart rate variability, and late decelerations, leading to a diagnosis of non-reassuring fetal status. We performed an emergency cesarean section. We found a segmented placenta with a mangrove-like attachment of the umbilical cord to the placenta and a histopathological examination showed chorioamnionitis. The newborn was markedly anemic with a hemoglobin concentration of 7.8 g/dL, but early delivery and blood transfusion saved her life. By close inspection, we thought anemia was caused by umbilical cord vessel rapture. Based on progress of the disease and the placental findings, we suggested umbilical cord vessel rapture was caused by umbilical cord inflammation with thrombosis formed in the fragile vessel of velamentous cord insertion. [Adv Obstet Gynecol, 75(3) : 301- 307, 2023 (R5.8)]

A case of fetal anemia caused by rupture of umbilical cord blood vessels with mangrove-like velamentous cord insertion

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