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Obstetrics & Gynecology 1999;93:828-829
© 1999 by The American College of Obstetricians and Gynecologists
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OBSTETRICS

UMBILICAL ARTERY REGRESSION: A RARE COMPLICATION OF INTRAVASCULAR FETAL TRANSFUSION

James F. Smith, Jr, MD, Kim D. Warner, MD, Michele Bergmann, MD and Michael J. Pushchak, MD

From the Departments of Obstetrics and Gynecology, and Pathology, Exempla Healthcare St. Joseph Hospital, Denver, Colorado.

Address reprint requests to: James F. Smith, Jr, MD Obstetrix Medical Group of Colorado 1601 East 19th Avenue, Suite 6500 Denver, CO 80218 E-mail: smithmfm{at}aol.com

Background: Intravascular fetal transfusion is an important therapeutic advance but is associated with several complications. Regression of an umbilical artery associated with transfusion is rare.

Case: A case of red blood cell alloimmunization managed by serial transfusions was complicated by functional loss of an umbilical artery during pregnancy. Refractory fetal bradycardia occurred during the last transfusion procedure, requiring emergency preterm cesarean delivery. Coagulative necrosis, thrombosis, and focal calcification of one umbilical artery was confirmed after delivery.

Conclusion: Umbilical artery regression associated with transfusion therapy is rare and may complicate subsequent fetal transfusions.






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