Lean Umbilical Cord – a Case Report

Abstract

The “lean” umbilical cord (also known as thin-cord syndrome) is a comparatively rare anomaly of the umbilical cord, which has seldom been described in the medical literature. We report on a 35-year-old women who presented to us at 29 + 4 weeks gestation with vaginal bleeding and cervical incompetence subsequently complicated not only by premature rupture of membranes but also acute placental insufficiency requiring emergency caesarean section under general anaesthesia at 31 + 2 weeks gestation. At surgery no obvious cause for the acute placental insufficiency – such as placental abruption, cord prolapse or true knot of the umbilical cord – was found. Other possible causes such as vasa praevia or placenta praevia had previously been excluded sonographically on admission for vaginal bleeding. The only notable intraoperative finding was a macroscopically extremely thin umbilical cord.

Zusammenfassung

Der sogenannte Thin-Cord-Komplex ist eine relativ seltene Nabelschnurpathologie, die bisher in der Literatur nur wenig beschrieben wurde. Wir berichten über eine 35-jährige Patientin, die sich seit der 29 + 4 Schwangerschaftswoche in unserer stationären Behandlung bei vaginaler Blutung sowie Zervixinsuffizienz befand und bei der es im klinischen Verlauf nicht nur zu einem vorzeitigen Blasensprung, sondern auch zu einer akuten Plazentainsuffizienz mit Entbindung per Notsectio in Intubationsnarkose in der 31 + 2 Schwangerschaftswoche kam. Intraoperativ zeigte sich kein Anhaltspunkt für Ursachen einer akuten Plazentainsuffizienz wie vorzeitige Plazentalösung, Nabelschnurvorfall bei vorzeitigem Blasensprung oder Nabelschnurknoten. Andere Ursachen wie Vasa praevia oder Placenta praevia bei vaginaler Blutung als Aufnahmegrund wurden bereits im Vorfeld sonografisch ausgeschlossen. Lediglich fiel intraoperativ eine makroskopisch äußerst dünne Nabelschnur auf.

Key words

umbilical cord anomaly - thin-cord syndrome - placental insufficiency - Whartonʼs jelly

Schlüsselwörter

Nabelschnuranomalie - Thin-Cord-Komplex - Plazentainsuffizienz - Wharton-Sulze

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