Umbilical Cord Vascular Complications in Pregnancy
Summary
Umbilical cord vascular complications encompass a spectrum of conditions that compromise blood flow between the placenta and the foetus, including thrombosis, true knots, varices and single-vessel anomalies. These disorders may arise from mechanical factors, hypercoagulable states, vessel wall injury or abnormal cord coiling, and are implicated in intrauterine growth restriction, foetal hypoxia, preterm birth and stillbirth. Prenatal diagnosis relies chiefly on two-dimensional ultrasound and colour Doppler assessment of umbilical vessels, supplemented by emerging biomarkers of endothelial activation. Management strategies range from intensified surveillance with serial Doppler studies and biophysical profiling to timely intervention, often via induction or surgical delivery when vascular compromise is evident. Globally, these complications carry a significant burden, particularly in low-resource settings where access to advanced imaging and neonatal support is limited. Ongoing research focuses on refining risk stratification, evaluating pharmacological prophylaxis and exploring the molecular pathways of cord vascular injury to inform tailored clinical pathways and improve perinatal outcomes.
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Umbilical Cord Vascular Complications in Pregnancy publication trend
The graph below shows the total number of articles in umbilical cord vascular complications in pregnancy across all publications each year (not limited to Nature Index journals).
Technical terms
Umbilical artery thrombosis: Formation of a blood clot within one or both umbilical arteries, impeding foetal blood return.
Doppler ultrasound: Imaging modality that measures blood flow velocity in foetal vessels to assess circulatory health.
Intrauterine growth restriction (IUGR): Failure of the foetus to achieve expected growth, often due to placental or vascular insufficiency.
Umbilical vein varix: Localised dilation of the umbilical vein, potentially predisposing to thrombosis or rupture.
Vasa praevia: Foetal vessels crossing or near the cervical os, at risk of laceration during labour.
References
- Expectant management for umbilical artery thrombosis in the third trimester of pregnancy: a case report. Frontiers in Pharmacology (2024).
- Hemodynamic changes and perinatal outcome associated with umbilical artery thrombosis: a retrospective study. Orphanet Journal of Rare Diseases (2024).
- Application of low molecular weight heparins in umbilical artery thrombosis: A case series and review of the literature. Medicine (2023).
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