Umbilical artery aneurysm without aneuploidy and delivery of a live neonate

IF 0.1 Q4 OBSTETRICS & GYNECOLOGY

Case Reports in Perinatal Medicine Pub Date : 2022-01-01 DOI:10.1515/crpm-2021-0091

G. Lewis, J. Dawkins, Xiangna Tang

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引用次数: 0

Abstract

Abstract Objectives Umbilical artery aneurysm, a rare structural anomaly of the umbilical cord, is frequently associated with fetal aneuploidy, fetal growth restriction and fetal demise. At present there are no definitive protocols or guidelines for the surveillance and management of this condition. Case presentation The index case is an 18-year-old primigravida who had an ultrasound at 35 weeks and 5 days gestation due to lagging symphysio-fundal height measurement. The ultrasound scan revealed a normal fetus with estimated fetal weight that was appropriate for gestational age. There was a cystic structure with internal echoes originating from the placenta at the point of the umbilical cord insertion, which was determined to be a 1.9 × 1.8 cm umbilical artery aneurysm on 3D and Doppler imaging. On follow up imaging the aneurysm had increased in size and measured 3.06 × 1.79 cm. The patient subsequently had a cesarean section delivery of a live female. Karyotyping subsequently revealed 46 XX. Conclusions A total of 15 cases of umbilical artery aneurysm have been reported in the literature to date, of which there were 5 live born infants with normal karyotype. The remaining 10 cases were intra-uterine fetal demise or trisomy 18 with subsequent neonatal deaths. When monitoring the aneurysms with ultrasound, change in size and Doppler indices play a pivotal role in helping to determine time and mode of delivery and thus allow for a favorable perinatal outcome.

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无非整倍体的脐动脉瘤和新生儿的活产

摘要目的脐动脉动脉瘤是一种罕见的脐带结构异常，通常与胎儿非整倍体、胎儿生长受限和胎儿死亡有关。目前还没有明确的方案或指导方针来监测和管理这种情况。病例介绍:本病例为18岁的初孕女性，妊娠35周5天因联合生理-子宫高度测量滞后接受超声检查。超声扫描显示胎儿正常，估计胎儿体重与胎龄相符。在脐带插入处可见囊性结构，内部回声来自胎盘，三维及多普勒成像确定为1.9 × 1.8 cm脐动脉瘤。在随访影像中，动脉瘤增大，尺寸为3.06 × 1.79 cm。该患者随后接受了剖宫产术，产下一名活的女性。核型分析显示46 XX。结论文献报道脐动脉瘤共15例，其中5例出生婴儿核型正常。其余10例为子宫内胎儿死亡或18三体伴新生儿死亡。超声监测动脉瘤时，大小和多普勒指数的变化在帮助确定分娩时间和方式方面起着关键作用，从而有利于围产期预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Case Reports in Perinatal Medicine OBSTETRICS & GYNECOLOGY-

自引率

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期刊介绍： Case Reports in Perinatal Medicine is a double-blind peer-reviewed journal. The objective of the new journal is very similar to that of JPM. In addition to evidence-based studies, practitioners in clinical practice esteem especially exemplary reports of cases that reveal specific manifestations of diseases, its progress or its treatment. We consider case reports and series to be brief reports describing an isolated clinical case or a small number of cases. They may describe new or uncommon diagnoses, unusual outcomes or prognosis, new or infrequently used therapies and side effects of therapy not usually discovered in clinical trials. They represent the basic concept of experiences for studies on representative groups for further evidence-based research. The potential roles of case reports and case series are: Recognition and description of new diseases Detection of drug side effects (adverse or beneficial) Study of mechanisms of disease Medical education and audit Recognition of rare manifestations of disease.