Umbilical cord ulceration complicating fetal upper gastrointestinal obstruction: a case report.
6 affiliations
- 1Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, 123 Tianfeixiang, Mochou Road, Nanjing, Jiangsu, 210004, China.
- 2Department of Reproductive Medicine, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, China.
- 3Department of Neonatology, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, China.
- 4Department of Pathology, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, China.
- 5Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, 123 Tianfeixiang, Mochou Road, Nanjing, Jiangsu, 210004, China. [email protected].
- 6Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, 123 Tianfeixiang, Mochou Road, Nanjing, Jiangsu, 210004, China. [email protected].
Abstract
Umbilical cord ulceration (UCU) is an uncommon but devastating cause of acute fetal hemorrhage, often associated with fetal upper gastrointestinal obstruction. We report a woman aged 30-35 years (gravida 4, para 1) referred at 23 weeks of gestation for suspected fetal gastrointestinal abnormality. Prenatal ultrasonography showed an enlarged fetal stomach with a double-bubble sign, and subsequent examinations demonstrated progressive polyhydramnios with increasing bowel dilatation. At 32 weeks and 4 days of gestation, after previously reassuring fetal assessment, the fetal heart rate suddenly fell and remained at 90-97 beats per minute, prompting emergency caesarean delivery. A large volume of blood stained amniotic fluid was noted and a longitudinal vessel rupture at the fetal end of the umbilical cord was identified with active bleeding. The neonate had profound anemia and died after withdrawal of care. Histopathology confirmed umbilical cord ulceration with vessel rupture and erythrocyte extravasation. This case highlights the abrupt onset of UCU and supports heightened surveillance when fetal upper gastrointestinal obstruction is suspected.
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BibTeX
@article{zhu2026umbilical,
title = {{Umbilical cord ulceration complicating fetal upper gastrointestinal obstruction: a case report.}},
author = {Yuanyuan Zhu and Tangyi Geng and Miao Qian and Yun Gu and Li Zhang and Rui Zhang},
journal = {BMC pregnancy and childbirth},
year = {2026},
month = jul,
doi = {10.1186/s12884-026-09666-1},
url = {https://europepmc.org/article/MED/42902241},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Umbilical cord ulceration complicating fetal upper gastrointestinal obstruction: a case report.
AU - Yuanyuan Zhu
AU - Tangyi Geng
AU - Miao Qian
AU - Yun Gu
AU - Li Zhang
AU - Rui Zhang
PY - 2026
DA - 2026/07/01
JO - BMC pregnancy and childbirth
DO - 10.1186/s12884-026-09666-1
UR - https://europepmc.org/article/MED/42902241
AB - Umbilical cord ulceration (UCU) is an uncommon but devastating cause of acute fetal hemorrhage, often associated with fetal upper gastrointestinal obstruction. We report a woman aged 30-35 years (gravida 4, para 1) referred at 23 weeks of gestation for suspected fetal gastrointestinal abnormality. Prenatal ultrasonography showed an enlarged fetal stomach with a double-bubble sign, and subsequent examinations demonstrated progressive polyhydramnios with increasing bowel dilatation. At 32 weeks and 4 days of gestation, after previously reassuring fetal assessment, the fetal heart rate suddenly fell and remained at 90-97 beats per minute, prompting emergency caesarean delivery. A large volume of blood stained amniotic fluid was noted and a longitudinal vessel rupture at the fetal end of the umbilical cord was identified with active bleeding. The neonate had profound anemia and died after withdrawal of care. Histopathology confirmed umbilical cord ulceration with vessel rupture and erythrocyte extravasation. This case highlights the abrupt onset of UCU and supports heightened surveillance when fetal upper gastrointestinal obstruction is suspected.
SN - 1471-2393
ER -