Ultrasound blood flow characteristics changes in fetal umbilical artery thrombosis:A retrospective analysis  

作　　者：Si-Jie Hong Li-Wei Hong Xiao-Qin He Xiao-Hong Zhong 

机构地区：[1]Department of Ultrasound,Women and Children's Hospital,School of Medicine,Xiamen University,Xiamen 361000,Fujian Province,China [2]Ministry of Science and Education,Women and Children's Hospital,School of Medicine,Xiamen University,Xiamen 361000,Fujian Province,China

出　　处：《World Journal of Clinical Cases》2024年第2期240-248,共9页世界临床病例杂志

基　　金：Natural Science Foundation of Xiamen,No.3502Z202373120;and National Key R&D Program of China,No.2022YFF0606301.

摘　　要：BACKGROUND Umbilical artery thrombosis(UAT)is extremely uncommon and leads to adverse perinatal outcomes.Hypercoagulation of blood in pregnant women is suspected to be an important risk for UAT.Ultrasound is an effective way to detect thrombosis.The mother can monitor her own fetal health using ultrasound,which enables her to take preventative action in case of emergency.AIM To investigate ultrasonic blood signal after UAT in the umbilical artery,and evaluate the relationship between hypercoagulability and UAT.METHODS We described a case of a newly formed UAT with markedly altered ultrasonic indices of umbilical artery blood flow,and retrospectively studied it with 18 UAT patients confirmed by histopathology from October 2019 and March 2023 in Xiamen Women and Children's Hospital.Patients’information was collected from medical archives,including maternal clinical data,neonatal outcomes,pathological findings and ultrasonic indices of umbilical artery blood flow,such as systolic-diastolic duration ratio(S/D),resistance index(RI),pulsatility index(PI)and peak systolic velocity(PSV).Ultrasound and coagulation indices were analyzed with matched samples t-test and Wilcoxon rank sum test using the statistical packages in R(version 4.2.1)including car(version 3.1-0)and stats(version 4.2.1),and visualized by ggplot2 package(version 3.3.6).RESULTS A patient with normal findings in second and third-trimester routine ultrasound scan developed UAT with severe changes in ultrasonic indices of umbilical artery blood flow(within 2.5th of reference ranges)in a short period of time.Statistical analysis of umbilical artery blood flow ultrasound indices for 19 patients with UAT showed that the decrease in S/D,RI,and PI and increase of PSV during the disease process was greater than that of non-UAT.All 18 patients delivered in our hospital showed characteristic manifestations of UAT on histological examination after delivery,most of which(16/18)showed umbilical cord abnormalities,with 15 umbilical cord torsion and 1 pseudoknot.Coag

关 键 词：Umbilical artery thrombosis Obstetric ultrasonography Peak systolic velocity HYPERCOAGULATION Umbilical cord abnormalities FETUS 

分 类 号：R714.5[医药卫生—妇产科学]