7 cases of umbilical cord thrombosis in diferent gestational ages

Background: ：Umbilical artery thrombosis is very rare and not easily detected by prenatal examination, but it can lead to adverse perinatal outcomes. Objective: ：To investigate the clinical manifestations related to umbilical artery thrombosis, and to evaluate the best treatment plan and delivery mode. Methods: ：Seven patients with umbilical artery thrombosis treated in Shandong Provincial Hospital from June 2020 to June 2022 were retrospectively studied. The patient's general condition (age, pregnancy complications, clinical manifestations, prenatal ultrasound), pregnancy outcome (mode of delivery, fetal outcomes) and clinical pathological characteristics of placentas were analyzed. Descriptive statistics were used to analyze the data. Result: ：Except for one patient who was lost to follow-up, all patients (6/7) were delivered by cesarean section; blood clots in umbilical arteries were observed in all patients. Clinical pathological characteristics of placentas included blood stasis umbilical artery (6/6) and chorioamnionitis (2/4). Clinical diagnosis showed that the main symptoms were abnormal fetal heart monitoring (7/7), reduced fetal movement (2/7), the number of umbilical arteries changed indicated by ultrasound (4/7) and excessive umbilical cord torsion (2/7). All neonates survived, 5 (5/6) were transferred to neonatology for treatment, 4 (4/6) were premature, 2 (2/4) were low birth weight, and 1 (1/4) was very low birth weight. Conclusion: We observed abnormal fetal heart monitoring, reduced number of fetal movements, prenatal ultrasound indicated changes in the number of umbilical arteries helped us to identify umbilical artery thrombosis early. Our results support emergency cesarean section as a method for better maternal and infant outcomes.