[Spontaneous umbilical cord hematoma, a rare cause of acute fetal distress].
BACKGROUND
Spontaneous umbilical cord hematoma is a rare life-threatening gestational accident.


METHODS
A 26 year-old primipara was examined at 38 weeks of gestation for fetal monitoring. There were a number of fetal decelerations with loss of baseline variability. Cesarean section performed for acute fetal distress resulted in a male infant with an Apgar score of 3 at 1 minute and 7 at 5 minutes and neonatal anemia (Hb: 11.6 g/l). Four umbilical cord hematomas were observed. Microscopic examination revealed a ruptured umbilical vein without other abnormality. Post natal evolution was marked by hypoxic-ischemic encephalopathy and death.


CONCLUSIONS
Spontaneous umbilical cord hematoma is rare (1/5,500 births) and often due to rupture of the umbilical vein. Risk factors are shortness or traction of the cord, post-maturity and infection. Umbilical cord hematomas are usually responsible for severe fetal distress or death.
Service de réanimation et néonatalogie, CHU, Brest, France.
J
J
Sizun
D
D
Soupre
L
L
Broussine
J D
JD
Giroux
P
P
Piriou
E
E
Ventrillon
D
D
Alix
L
L
de Parscau
D000208:Acute Disease; D000328:Adult; D005260:Female; D005316:Fetal Distress / Q000209:etiology*; D006406:Hematoma / Q000150:complications*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D014470:Umbilical Cord
L'hématome spontané du cordon: une cause rare de souffrance foetale aiguë.