{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:36:05Z","timestamp":1787016965637,"version":"build-2736575974"},"reference-count":18,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,4,6]]},"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:p>Umbilical cord rupture (UCR) in utero is a very rare and critical emergency that can cause fetal death within minutes. A 38-year-old nulliparous woman was admitted at 39 weeks in labour. Sudden watery vaginal discharge and bleeding with a rapid drop in the fetal heart rate to 60 beats\/min necessitated an emergency caesarean section. A male infant weighing 2632 g was delivered 21\u2009min after the onset of bradycardia; Apgar scores were 0 and 1 at 1 and 5\u2009min, respectively. He was extremely pale; the umbilical arterial blood pH was 6.89 and haemoglobin was 9.0 g\/dL. The umbilical cord had a velamentous insertion and was lacerated, with haemorrhage in the outer layer of an umbilical artery close to the placental end. The presentation was typical of UCR: vaginal bleeding following the rupture of membranes. Prompt diagnosis of UCR and termination of pregnancy are essential for fetal survival.<\/jats:p>","DOI":"10.1136\/bcr-2020-240245","type":"journal-article","created":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T12:52:55Z","timestamp":1618836775000},"page":"e240245","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Velamentous cord insertion ruptured during labour leading to acute fetal blood loss"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6056-8824","authenticated-orcid":false,"given":"Takeshi","family":"Nagao","sequence":"first","affiliation":[{"name":"Integrated Women's Health, St Luke's International Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erisa","family":"Kuriyama","sequence":"additional","affiliation":[{"name":"Integrated Women's Health, St Luke's International Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ami","family":"Sato","sequence":"additional","affiliation":[{"name":"Integrated Women's Health, St Luke's International Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiko","family":"Yamanaka","sequence":"additional","affiliation":[{"name":"Integrated Women's Health, St Luke's International Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,4,19]]},"reference":[{"key":"2025082801160710000_14.4.e240245.1","first-page":"107","article-title":"Umbilical cord rupture: a case report and review of literature","volume":"52","author":"Naidu","year":"2007","journal-title":"Int J Fertil Womens Med"},{"key":"2025082801160710000_14.4.e240245.2","doi-asserted-by":"crossref","DOI":"10.1186\/s13643-020-01355-0","article-title":"Velamentous cord insertion: results from a rapid review of incidence, risk factors, adverse outcomes and screening","volume":"9","author":"Buchanan-Hughes","year":"2020","journal-title":"Syst Rev"},{"key":"2025082801160710000_14.4.e240245.3","first-page":"126","article-title":"Velamentous insertion of umbilical cord with vasa praevia: case series and literature review","volume":"9","author":"Boh\u00eel\u021bea","year":"2016","journal-title":"J Med Life"},{"key":"2025082801160710000_14.4.e240245.4","first-page":"1462","article-title":"Evaluation of anemia in children","volume":"81","author":"Janus","year":"2010","journal-title":"Am Fam Physician"},{"key":"2025082801160710000_14.4.e240245.5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2007.01327.x"},{"key":"2025082801160710000_14.4.e240245.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(85)80149-9"},{"key":"2025082801160710000_14.4.e240245.7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15761\/CCRR.1000433","article-title":"Rupture of umbilical cord at birth: an unusual case of acute neonatal haemorrhage","volume":"4","author":"De Petris","year":"2018","journal-title":"Clin Case Rep Rev"},{"key":"2025082801160710000_14.4.e240245.8","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318193beaf"},{"key":"2025082801160710000_14.4.e240245.9","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/0028-2243(80)90034-9","article-title":"Intrauterine rupture of the umbilical cord during delivery","volume":"10","author":"Itskovitz","year":"1980","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"2025082801160710000_14.4.e240245.10","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1055\/s-2006-934101","article-title":"Sudden fetal death associated with both duodenal atresia and umbilical cord ulcer: a case report and review","volume":"23","author":"Anami","year":"2006","journal-title":"Am J Perinatol"},{"key":"2025082801160710000_14.4.e240245.11","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1007\/s00404-006-0214-3","article-title":"Intrauterine hemorrhage from an umbilical cord ulcer associated with fetal duodenal atresia: a case report","volume":"275","author":"Hidaka","year":"2007","journal-title":"Arch Gynecol Obstet"},{"key":"2025082801160710000_14.4.e240245.12","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1016\/S1701-2163(16)34282-7","article-title":"Guidelines for the management of vasa previa","volume":"31","author":"Gagnon","year":"2009","journal-title":"J Obstet Gynaecol Can"},{"key":"2025082801160710000_14.4.e240245.13","first-page":"181","article-title":"Fetal circulatory responses to oxygen lack","volume":"16","author":"Jensen","year":"1991","journal-title":"J Dev Physiol"},{"key":"2025082801160710000_14.4.e240245.14","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1111\/aogs.13985","article-title":"Bradycardia-to-delivery interval and fetal outcomes in umbilical cord prolapse","volume":"100","author":"Wong","year":"2021","journal-title":"Acta Obstet Gynecol Scand"},{"key":"2025082801160710000_14.4.e240245.15","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1002\/uog.2839","article-title":"Cord insertion into the lower third of the uterus in the first trimester is associated with placental and umbilical cord abnormalities","volume":"28","author":"Hasegawa","year":"2006","journal-title":"Ultrasound Obstet Gynecol"},{"key":"2025082801160710000_14.4.e240245.16","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1007\/s00404-015-3912-x","article-title":"Velamentous cord insertion as a risk factor for obstetric outcome: a retrospective case-control study","volume":"293","author":"Yerlikaya","year":"2016","journal-title":"Arch Gynecol Obstet"},{"key":"2025082801160710000_14.4.e240245.17","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1002\/ijgo.12489","article-title":"A systematic review and meta-analysis of velamentous cord insertion among singleton pregnancies and the risk of preterm delivery","volume":"142","author":"de Los Reyes","year":"2018","journal-title":"Int J Gynaecol Obstet"},{"key":"2025082801160710000_14.4.e240245.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.05.058"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-240245","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:16:13Z","timestamp":1756368973000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-240245"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4]]},"references-count":18,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,4,19]]},"published-print":{"date-parts":[[2021,4]]}},"alternative-id":["10.1136\/bcr-2020-240245"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-240245","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4]]}}}