Thrombosis is blockage or obstruction in the blood vessel due to a blood clot. Thrombosis of umbilical cord is a rare phenomenon but when it occurs it is life threatening event. On an average 1 out of 1300 deliveries is known to be affected with umbilical cord thrombosis. The umbilical cord consists of two umbilical arteries and one umbilical vein.
Thrombosis most often occurs in umbilical vein as compared to umbilical arteries. The common risk factors include excessive twisting of umbilical cord, multiple pregnancies, large sized baby, abnormal insertion of umbilical cord in the placenta etc.
The two main serious symptoms this abnormality can produce is too much bleeding during delivery and fetal distress due to reduced supply of blood. Fetal monitoring is regularly required because of its adverse outcome. Thrombosis of umbilical cord is a medical emergency and most of these cases need early delivery by cesarean section to save the fetus.
Causes And Risk Factors For Thrombosis Of Umbilical Cord
Thrombosis of umbilical cord is a rare complication of pregnancy. It increases mortality and morbidity of the fetus. The exact cause of this condition is not known but there are several risk factors that are known to cause this condition.
Below are the risk factors that are usually associated with this condition:
- Excessive twisting of umbilical cord.
- Too short or too long cord. Short cord may stretch the vessels too much during labor which may cause damage to the vessels and eventual thrombosis.
- Large sized baby or multiple pregnancies.
- Inflammation of the umbilical cord caused due to infection, preeclampsia or phlebitis.
- The umbilical cord may get abnormally inserted in the placenta as in case of velamentous insertion or insertion at the margin of the placenta.
- Presence of diabetes in pregnant mother is known risk factor for formation of thrombus. This occurs because the mother has increased level of alpha 2 antiplasmin and low level of fibrinolysin. This may increase the risk of thrombosis.
Symptoms Of Thrombosis Of Umbilical Cord
The signs and symptoms of thrombosis of umbilical cord may be:
- Excessive bleeding or hemorrhage during child birth.
- Due to improper supply of blood to the fetus because of clot in the vein or the arteries, there may be fetal distress. In many cases fetal growth is retarded due to lack of nutrition.
- Most thrombosis of umbilical cord is noted in third trimester of pregnancy.
- Increased risk of stillbirth.
Treatment For Thrombosis Of Umbilical Cord
Thrombosis of umbilical cord can turn into medical emergency as it may risk the life of fetus and increase perinatal morbidity. There is associated risk of increase bleeding. Treatment is thus focused to reduce the risk of complications and at the same time save the fetus.
Often elective caesarean section is recommended by the doctor after assessing the condition of fetus and mother. Most fetuses will have fetal distress due to thrombosis of umbilical cord and to relieve it early elective caesarean section may be thought of.
There is no specific way that is available to prevent thrombosis of umbilical cord.
Prognosis: Thrombosis of umbilical cord is life threatening for the fetus. It has high mortality rate with 60 percent resulting in termination of pregnancy. Delay in treatment may cause death of the fetus. Or it may cause severe health complication in the newborn. The prognosis is worse when the umbilical artery is thrombosed.