Umbilical Cord Hematoma and Uterine Torsion: Rare Pregnancy Complications at Tu Du Hospital in Vietnam and Review of Literature
Abstract
Objective: Umbilical cord hematoma and uterine torsion are extremely rare complications in pregnancy. However, these should not be neglected in clinical practice in condition of abnormal fetal heart monitoring without others suspects. We hereby report rare case of umbilical cord hematoma and uterine torsion as well as review the literature. Through this report, we aim to mention on an available tool to investigate spontaneous umbilical cord hematoma on fetal well-being in such a case.
Case report: A women aged 35 years old (G1P0) admitted to our hospital for term gestation with uncomplicated pregnancy, except large uterine fibroid accompanied with cervical pessary. Then, an uncommon complication of umbilical cord hematoma was revealed accidentally upon cesarean section. Particularly, this dramatic event was happened along with an asymptomatic uterine torsion noticed at the same time. Preoperative diagnosis of two rare complications was missed, hence, we extracted timely baby based on another modality of management, computerized cardiotocography.
Conclusion: Umbilical cord hematoma along with uterine torsion is difficult to diagnosis due to its rarity. Moreover, no available tool could investigate umbilical cord hematoma prior to delivery. Surveillance on fetal heart rate monitoring may be helpful in this situation.
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2. Sizun J, Soupre D, Broussine L, Giroux JD, Piriou P, Ventrillon E, et al. (Spontaneous umbilical cord hematoma, a rare cause of acute fetal distress). Arch Pediatr 1995; 2: 1182-3.
3. Benirschke K, Kaufmann P, Baergen R. Anatomy and Pathology of the Umbilical Cord. Pathology of the Human Placenta . Springer , Fifth Edition , New York, USA 2006.
4. Basta M, Lipsett BJ. Anatomy, Abdomen and Pelvis, Umbilical Cord. 2021 Jul 31. In: StatPearls (Internet). Treasure Island (FL): StatPearls Publishing; 2022.
5. Wang Y, Zhao S. Vascular Biology of the Placenta. San Rafael (CA): Morgan & Claypool Life Sciences; 2010.
6. Tonni G, Bonasoni MP, De Felice C, Rossi A, Tonni S. Histopathological Findings in Spontaneous Hematoma of the Umbilical Cord: Severe Hypoxic-Ischemic Encephalopathy in a Term Survived Newborn. Am J Forensic Med Pathol 2015; 36: 254-6.
7. Jouannelle C, Giansily-Blaizot M, Monpoux F, Casagrande F, Poirée M, Bérard E. Spontaneous umbilical cord haematoma and congenital factor VII
deficiency. Haemophilia 2012; 18: e24-5.
8. Scutiero G, Giulia B, Iannone P, Nappi L, Morano D, Greco P. Umbilical Cord Hematoma: A Case Report and Review of the Literature. Obstet Gynecol Int 2018; 2018: 2610980.
9. McAdams RM, Chabra S. Umbilical cord haematoma and adrenal haemorrhage in a macrosomic neonate with anaemia. BMJ Case Rep 2016; 2016: bcr2015214140.
10. Hooper KE, Sebire PSpontaneous umbilical cord haematomaArchives of Disease in Childhood - Fetal and Neonatal Edition 2016; 101: F332.
11. Koukoura O, Sveronis G, Alevra Z, Gaitana K, Kalaitzi AN, Dafoulis N, et al. Spontaneous cord hematoma: report of two cases. J Case Reports in Perinatal Medicine 2016; 5: 97-9.
12. Arora PK, Mohandas S, McAndrew S, Karody V. Spontaneous Umbilical Cord Hematoma. The J Pediatr 2017; 184: 233-233.e1.
13. Skowronek R, Zamłyński M, Kajor M, Zamłyński J, Chowaniec M. Spontaneous umbilical cord hematoma as a clinical and forensic medical problem in case of suspected obstetrician’s medical malpractice. Ginekologia Polska 2018; 89: 642-3.
14. Mota F, Oliveira N, Fonseca M, Mimoso G. Spontaneous umbilical cord haematoma. BMJ Case Rep 2019; 12(6):e229952.
15. Khatiwada P, Alsabri M, Wiredu S, Kusum V, Kiran V. Spontaneous Umbilical Cord Hematoma. Cureus. 2021 Feb 1;13(2):e13048.
16. Mantakas X, Dalivigkas I, Aravantinos L, Goutas N, Goudeli C, Vlahos N. Placenta and Umbilical Cord Cause in Antepartum Deaths. Cureus 2018; 10: e3556.
17. Sepulveda W, Wong AE, Gonzalez R, Vasquez P, Gutierrez J. Fetal death due to umbilical cord hematoma: a rare complication of umbilical cord cyst.
J Matern Fetal Neonatal Med 2005; 18: 387-90.
18. Brown R, Nicolaides K. Umbilical cord hematoma associated with an umbilical cord cyst and fetal death at 28 weeks of gestation. J Ultrasound Med 2000; 19: 223-5.
19. Antolin E, Castelo-branco C, Lopez A, Martinez JM, Torné A. Umbilical cord torsion; a rare cause of intra-uterine fetal death. Journal of Obstetrics and Gynaecology 1994; 14: 324-5.
20. Gualandri G, Rivasi F, Santunione AL, Silingardi E. Spontaneous umbilical cord hematoma: an unusual cause of fetal mortality: a report of 3 cases and review of the literature. Am J Forensic Med Pathol 2008; 29: 185-90.
21. Chua KJ, Patel R, Eana A, Varughese J. Uterine torsion
with necrosis of bilateral adnexa in a postmenopausal woman. BMJ Case Rep. 2019; 12(6): e229311.
22. Rood K, Markham KB. Torsion of a Term Gravid Uterus: A Possible Cause of Intrauterine Growth Restriction and Abnormal Umbilical Artery Doppler Findings. J Ultrasound Med 2014; 33: 1873-5.
23. Kilicci C, Sanverdi I, Bostanci E, Abide CY, Eser SK. Uterine torsion of 720 degrees in the third trimester of pregnancy and accompanying bladder torsion: a case report. Pan Afr Med J 2018; 29: 175.
24. Liang R, Gandhi J, Rahmani B, Khan SA. Uterine torsion: A review with critical considerations for the obstetrician and gynecologist. Translational Research in Anatomy 2020; 21: 100084.
25. Ferrari F, Ferrari FA, Negri B, Forte S, Franceschetti L, Sartori E, et al. Uterine torsion and intrauterine growth restriction: Case report and systematic literature review. J Obstet Gynaecol Res 2021; 47: 4224-31.
26. Kocher M, Hirsig L. A case of uterine incarceration with unrecognized uterine torsion. Radiol Case Rep 2020; 15(10): 1943-7.
27. Serra V, Moulden M, Bellver J, Redman CW. The value of the short-term fetal heart rate variation for
timing the delivery of growth-retarded fetuses. BJOG 2008; 115: 1101-7.
28. Wretler S, Holzmann M, Graner S, Lindqvist P, Falck S, Nordström L. Fetal heart rate monitoring of short term variation (STV): a methodological observational study. BMC Pregnancy Childbirth 2016; 16: 55.
29. Towers CV, Juratsch CE, Garite TJ. The fetal heart monitor tracing in pregnancies complicated by a spontaneous umbilical cord hematoma. Journal of Perinatology. 2009;29(7):517-20.
30. Barbati A, Cacace MG, Fratini D, Ceccarelli T, Capanna F, Di Renzo GC. Umbilical cord haematoma with altered fetal heart rate. Journal of Obstetrics and Gynaecology. 2009;29(2):150-1.
2. Sizun J, Soupre D, Broussine L, Giroux JD, Piriou P, Ventrillon E, et al. (Spontaneous umbilical cord hematoma, a rare cause of acute fetal distress). Arch Pediatr 1995; 2: 1182-3.
3. Benirschke K, Kaufmann P, Baergen R. Anatomy and Pathology of the Umbilical Cord. Pathology of the Human Placenta . Springer , Fifth Edition , New York, USA 2006.
4. Basta M, Lipsett BJ. Anatomy, Abdomen and Pelvis, Umbilical Cord. 2021 Jul 31. In: StatPearls (Internet). Treasure Island (FL): StatPearls Publishing; 2022.
5. Wang Y, Zhao S. Vascular Biology of the Placenta. San Rafael (CA): Morgan & Claypool Life Sciences; 2010.
6. Tonni G, Bonasoni MP, De Felice C, Rossi A, Tonni S. Histopathological Findings in Spontaneous Hematoma of the Umbilical Cord: Severe Hypoxic-Ischemic Encephalopathy in a Term Survived Newborn. Am J Forensic Med Pathol 2015; 36: 254-6.
7. Jouannelle C, Giansily-Blaizot M, Monpoux F, Casagrande F, Poirée M, Bérard E. Spontaneous umbilical cord haematoma and congenital factor VII
deficiency. Haemophilia 2012; 18: e24-5.
8. Scutiero G, Giulia B, Iannone P, Nappi L, Morano D, Greco P. Umbilical Cord Hematoma: A Case Report and Review of the Literature. Obstet Gynecol Int 2018; 2018: 2610980.
9. McAdams RM, Chabra S. Umbilical cord haematoma and adrenal haemorrhage in a macrosomic neonate with anaemia. BMJ Case Rep 2016; 2016: bcr2015214140.
10. Hooper KE, Sebire PSpontaneous umbilical cord haematomaArchives of Disease in Childhood - Fetal and Neonatal Edition 2016; 101: F332.
11. Koukoura O, Sveronis G, Alevra Z, Gaitana K, Kalaitzi AN, Dafoulis N, et al. Spontaneous cord hematoma: report of two cases. J Case Reports in Perinatal Medicine 2016; 5: 97-9.
12. Arora PK, Mohandas S, McAndrew S, Karody V. Spontaneous Umbilical Cord Hematoma. The J Pediatr 2017; 184: 233-233.e1.
13. Skowronek R, Zamłyński M, Kajor M, Zamłyński J, Chowaniec M. Spontaneous umbilical cord hematoma as a clinical and forensic medical problem in case of suspected obstetrician’s medical malpractice. Ginekologia Polska 2018; 89: 642-3.
14. Mota F, Oliveira N, Fonseca M, Mimoso G. Spontaneous umbilical cord haematoma. BMJ Case Rep 2019; 12(6):e229952.
15. Khatiwada P, Alsabri M, Wiredu S, Kusum V, Kiran V. Spontaneous Umbilical Cord Hematoma. Cureus. 2021 Feb 1;13(2):e13048.
16. Mantakas X, Dalivigkas I, Aravantinos L, Goutas N, Goudeli C, Vlahos N. Placenta and Umbilical Cord Cause in Antepartum Deaths. Cureus 2018; 10: e3556.
17. Sepulveda W, Wong AE, Gonzalez R, Vasquez P, Gutierrez J. Fetal death due to umbilical cord hematoma: a rare complication of umbilical cord cyst.
J Matern Fetal Neonatal Med 2005; 18: 387-90.
18. Brown R, Nicolaides K. Umbilical cord hematoma associated with an umbilical cord cyst and fetal death at 28 weeks of gestation. J Ultrasound Med 2000; 19: 223-5.
19. Antolin E, Castelo-branco C, Lopez A, Martinez JM, Torné A. Umbilical cord torsion; a rare cause of intra-uterine fetal death. Journal of Obstetrics and Gynaecology 1994; 14: 324-5.
20. Gualandri G, Rivasi F, Santunione AL, Silingardi E. Spontaneous umbilical cord hematoma: an unusual cause of fetal mortality: a report of 3 cases and review of the literature. Am J Forensic Med Pathol 2008; 29: 185-90.
21. Chua KJ, Patel R, Eana A, Varughese J. Uterine torsion
with necrosis of bilateral adnexa in a postmenopausal woman. BMJ Case Rep. 2019; 12(6): e229311.
22. Rood K, Markham KB. Torsion of a Term Gravid Uterus: A Possible Cause of Intrauterine Growth Restriction and Abnormal Umbilical Artery Doppler Findings. J Ultrasound Med 2014; 33: 1873-5.
23. Kilicci C, Sanverdi I, Bostanci E, Abide CY, Eser SK. Uterine torsion of 720 degrees in the third trimester of pregnancy and accompanying bladder torsion: a case report. Pan Afr Med J 2018; 29: 175.
24. Liang R, Gandhi J, Rahmani B, Khan SA. Uterine torsion: A review with critical considerations for the obstetrician and gynecologist. Translational Research in Anatomy 2020; 21: 100084.
25. Ferrari F, Ferrari FA, Negri B, Forte S, Franceschetti L, Sartori E, et al. Uterine torsion and intrauterine growth restriction: Case report and systematic literature review. J Obstet Gynaecol Res 2021; 47: 4224-31.
26. Kocher M, Hirsig L. A case of uterine incarceration with unrecognized uterine torsion. Radiol Case Rep 2020; 15(10): 1943-7.
27. Serra V, Moulden M, Bellver J, Redman CW. The value of the short-term fetal heart rate variation for
timing the delivery of growth-retarded fetuses. BJOG 2008; 115: 1101-7.
28. Wretler S, Holzmann M, Graner S, Lindqvist P, Falck S, Nordström L. Fetal heart rate monitoring of short term variation (STV): a methodological observational study. BMC Pregnancy Childbirth 2016; 16: 55.
29. Towers CV, Juratsch CE, Garite TJ. The fetal heart monitor tracing in pregnancies complicated by a spontaneous umbilical cord hematoma. Journal of Perinatology. 2009;29(7):517-20.
30. Barbati A, Cacace MG, Fratini D, Ceccarelli T, Capanna F, Di Renzo GC. Umbilical cord haematoma with altered fetal heart rate. Journal of Obstetrics and Gynaecology. 2009;29(2):150-1.
| Files | ||
| Issue | Vol 16, No 3 (September 2022) | |
| Section | Case Reports | |
| DOI | https://doi.org/10.18502/jfrh.v16i3.10585 | |
| Keywords | ||
| Umbilical Cord Hematoma Uterine Torsion Obstetrical Complications C-Section Computerized Cardiotocography | ||
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How to Cite
1.
Vuong ADB, Nguyen PN. Umbilical Cord Hematoma and Uterine Torsion: Rare Pregnancy Complications at Tu Du Hospital in Vietnam and Review of Literature. J Family Reprod Health. 2022;16(3):220-228.
