{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T01:02:19Z","timestamp":1781917339970,"version":"3.54.5"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,11,22]],"date-time":"2021-11-22T00:00:00Z","timestamp":1637539200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,11,22]],"date-time":"2021-11-22T00:00:00Z","timestamp":1637539200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pregnancy Childbirth"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Umbilical artery thrombosis is a rare complication of pregnancy strongly associated with poor fetal and perinatal outcomes, such as intrauterine asphyxia, fetal growth restriction, and stillbirth. Its pathogenesis remains unclear, and there is the added challenge of selecting an appropriate delivery time to achieve excellent neonatal outcomes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Our Hospital is a critical maternal rescue center with approximately 7000 births annually. We present a series of 8 cases of umbilical artery thrombosis diagnosed at the hospital between Apr 1, 2018, and Jan 31, 2020. We identified the cases through a keyword search of the maternity and pathology information management systems.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Three patients were diagnosed with a transabdominal ultrasound scan and hypoxia on fetal heart monitoring. All three patients had emergency cesarean section delivery. Four patients were observed closely for 5 to 13\u2009weeks from initial detection by an ultrasound scan to delivery. Only one patient was diagnosed after vaginal delivery by Hematoxylin-eosin staining of umbilical cord sections. Seven patients had deliveries by cesarean section, and one patient had a vaginal delivery. All infants were born alive.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Umbilical artery thrombosis is a challenging and rare condition that can occur at different gestational ages, especially when diagnosed in the third trimester and accompanied by fetal growth restriction. Consequently, these patients require close monitoring of umbilical blood flow and fetal growth and intervention at the appropriate time to achieve an optimal outcome.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12884-021-04264-9","type":"journal-article","created":{"date-parts":[[2021,11,22]],"date-time":"2021-11-22T08:05:39Z","timestamp":1637568339000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Umbilical artery thrombosis diagnosed at different gestational ages and fetal outcomes: a case series"],"prefix":"10.1186","volume":"21","author":[{"given":"Jing","family":"Wei","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiaoyun","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6652-4147","authenticated-orcid":false,"given":"Hongbo","family":"Zhai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,11,22]]},"reference":[{"key":"4264_CR1","doi-asserted-by":"publisher","first-page":"1164","DOI":"10.1080\/01443615.2017.1404012","volume":"38","author":"T Kitano","year":"2018","unstructured":"Kitano T, Ohgitani A, Takagi K, Arai I, Yasuhara H, Ebisu R, et al. A case of severe neonatal asphyxia due to umbilical artery thrombosis. J Obstet Gynaecol. 2018;38:1164\u20135.","journal-title":"J Obstet Gynaecol"},{"key":"4264_CR2","doi-asserted-by":"publisher","first-page":"1603","DOI":"10.7863\/jum.2009.28.12.1603","volume":"28","author":"JM Dicke","year":"2009","unstructured":"Dicke JM, Huettner P, Yan S, Odibo A, Kraus FT. Umbilical artery Doppler indices in small for gestational age fetuses: correlation with adverse outcomes and placental abnormalities. J Ultrasound Med. 2009;28:1603\u201310.","journal-title":"J Ultrasound Med"},{"key":"4264_CR3","doi-asserted-by":"publisher","first-page":"89","DOI":"10.2350\/13-11-1407-OA.1","volume":"17","author":"C Shilling","year":"2014","unstructured":"Shilling C, Walsh C, Downey P, Mooney E. Umbilical artery thrombosis is a rare but clinically important finding: a series of 7 cases with clinical outcomes. Pediatr Dev Pathol. 2014;17:89\u201393.","journal-title":"Pediatr Dev Pathol"},{"key":"4264_CR4","doi-asserted-by":"publisher","first-page":"e18170","DOI":"10.1097\/MD.0000000000018170","volume":"98","author":"H Li","year":"2019","unstructured":"Li H, Qufeng W, Wei W, Lin X, Zhang X. Umbilical artery thrombosis: Two case reports. Medicine (Baltimore). 2019;98:e18170.","journal-title":"Medicine (Baltimore)"},{"key":"4264_CR5","doi-asserted-by":"publisher","first-page":"37","DOI":"10.3109\/15513818809022278","volume":"8","author":"SA Heifetz","year":"1988","unstructured":"Heifetz SA. Thrombosis of the umbilical cord: analysis of 52 cases and literature review. Pediatr Pathol. 1988;8:37\u201354.","journal-title":"Pediatr Pathol"},{"key":"4264_CR6","doi-asserted-by":"publisher","first-page":"971","DOI":"10.1016\/j.humpath.2009.07.026","volume":"41","author":"L Avagliano","year":"2010","unstructured":"Avagliano L, Marconi AM, Candiani M, Barbera A, Bulfamante G. Thrombosis of the umbilical vessels revisited. An observational study of 317 consecutive autopsies at a single institution. Hum Pathol. 2010;41:971\u20139.","journal-title":"Hum Pathol"},{"key":"4264_CR7","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1093\/qjmed\/hcl070","volume":"99","author":"PC Malone","year":"2006","unstructured":"Malone PC, Agutter PS. The aetiology of deep venous thrombosis. QJM. 2006;99:581\u201393.","journal-title":"QJM"},{"key":"4264_CR8","first-page":"365","volume":"41","author":"MX Chew","year":"2019","unstructured":"Chew MX, Teoh PY, Wong YP, Tan GC. Multiple umbilical cord strictures in a case of intrauterine foetal demise. Malays J Pathol. 2019;41:365\u20138.","journal-title":"Malays J Pathol"},{"key":"4264_CR9","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1590\/1516-3180.2016.00081203","volume":"134","author":"GH Oliveira","year":"2016","unstructured":"Oliveira GH, Dias Cde M, Vaz-Oliani DC, Oliani AH. Intrauterine thrombosis of umbilical artery - case report. Sao Paulo Med J. 2016;134:355\u20138.","journal-title":"Sao Paulo Med J"},{"key":"4264_CR10","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1159\/000355601","volume":"35","author":"K Tanaka","year":"2014","unstructured":"Tanaka K, Tanigaki S, Matsushima M, Miyazaki N, Hashimoto R, Izawa T, et al. Prenatal diagnosis of umbilical artery thrombosis. Fetal Diagn Ther. 2014;35:148\u201350.","journal-title":"Fetal Diagn Ther"},{"key":"4264_CR11","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1016\/j.placenta.2008.01.004","volume":"29","author":"P Klaritsch","year":"2008","unstructured":"Klaritsch P, Haeusler M, Karpf E, Schlembach D, Lang U. Spontaneous intrauterine umbilical artery thrombosis leading to severe fetal growth restriction. Placenta. 2008;29:374\u20137.","journal-title":"Placenta"},{"key":"4264_CR12","first-page":"6324362","volume":"2018","author":"A Alhousseini","year":"2018","unstructured":"Alhousseini A, Jaiman S, Hernandez-Andrade E, Zeineddine S, Qureshi F, Jacques SM. Umbilical artery thrombosis with associated acute and severe fetal growth restriction and transient severe protein S deficiency: report of a case with prenatal ultrasound diagnosis allowing for timely intervention and good outcome. Case Rep Obstet Gynecol. 2018;2018:6324362.","journal-title":"Case Rep Obstet Gynecol"},{"key":"4264_CR13","first-page":"5952326","volume":"2019","author":"RV Donepudi","year":"2019","unstructured":"Donepudi RV, Moise KJ Jr. Intrauterine transfusion complicated by umbilical artery thrombosis. Case Rep Obstet Gynecol. 2019;2019:5952326.","journal-title":"Case Rep Obstet Gynecol"},{"key":"4264_CR14","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1016\/j.placenta.2005.05.008","volume":"27","author":"Y Sato","year":"2006","unstructured":"Sato Y, Benirschke K. Umbilical arterial thrombosis with vascular wall necrosis: clinicopathologic findings of 11 cases. Placenta. 2006;27:715\u20138.","journal-title":"Placenta"},{"issue":"1","key":"4264_CR15","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1007\/s00404-020-05910-x","volume":"304","author":"Y Zhu","year":"2021","unstructured":"Zhu Y, Beejadhursing R, Liu Y. 10 cases of umbilical cord thrombosis in the third trimester. Arch Gynecol Obstet. 2021;304(1):59\u201364.","journal-title":"Arch Gynecol Obstet"}],"container-title":["BMC Pregnancy and Childbirth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12884-021-04264-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12884-021-04264-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12884-021-04264-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,22]],"date-time":"2021-11-22T08:07:07Z","timestamp":1637568427000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpregnancychildbirth.biomedcentral.com\/articles\/10.1186\/s12884-021-04264-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,22]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["4264"],"URL":"https:\/\/doi.org\/10.1186\/s12884-021-04264-9","relation":{},"ISSN":["1471-2393"],"issn-type":[{"value":"1471-2393","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,22]]},"assertion":[{"value":"12 August 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 November 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 November 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The Medical Technology Application and Research Ethics Committee of Hangzhou First People\u2019s Hospital approved this study. All study participants gave verbal informed consent, this was approved by the Medical Technology Application and Research Ethics Committee of Hangzhou First People\u2019s Hospital as it was a retrospective study and no interventions was given to the participants. This manuscript reported adherence to Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"788"}}