|Case Study 5 - Umbilical Cord Compression without Entanglement|
A 28 year old white female G 3 P2 with two previous normal spontaneous vaginal deliveries at 34 weeks, noted decreased fetal movement at bed time. An overnight NST on labor and delivery detected fetal heart rate changes which prompted admission and an OCT. (Fig. 1,2). Previous ultra sound exams had identified a posterior placenta and marginal cord insertion (Fig. A&B). A confirmation of FHR changes led to betamethasone treatment to enhance lung maturity. A biophysical profile suggest decreased fetal movement and no breathing movement. Continued monitoring for five days repeatedly showed maternal sleep fetal heart rate decelerations with and without contractions (Fig. 3/4/5). An oxytocin stress test on day 6 exhibited FHR late decelerations (Fig. 6). A primary c-section delivered a viable 35 week male infant from a transverse. A posterior placenta with low lying marginal insertion over the sacrum was confirmed. Pathological study showed edematous umbilical cord and chorangiosis (Fig. 8).
The newborn weighing 5 pounds 3 ounces did well and all prenatal and postnatal labs and cult were normal. This case suggests cord compression occurred as described throughout this website. Pregnancy institute believes that the example of intermittent umbilical cord compression is a reliable explanation of house fetuses may be compromised and sometimes die. Not all fetuses have entanglement, but whether they do or don't, cord compression by any means is potentially damaging and ultimately deadly. Instructions to this patient to notify us of fetal movement changes (based on our observation of a susceptible umbilical cord insertion) was helpful. We recommend any patient complaint of fetal behavioral changes whether decreased movement or hyperactivity be met with a 24 hour overnight maternal/fetal monitoring non-stress test.
Figures A & B
This page developed and sponsored by