Successful amnioinfusion for severe fetal growth restriction with umbilical cord complications: two case reports
Abstract Background There is no established treatment for fetal growth restriction during pregnancy. We report two cases that represent an example of an amnioinfusion-based management strategy for severe fetal growth restriction with umbilical cord complications. Case presentation We encountered two...
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doaj-a200b40872ca429380a1651aa3b0cc362021-08-01T11:41:55ZengBMCJournal of Medical Case Reports1752-19472021-07-011511510.1186/s13256-021-02904-4Successful amnioinfusion for severe fetal growth restriction with umbilical cord complications: two case reportsDaisuke Katsura0Yuichiro Takahashi1Shigenori Iwagaki2Rika Chiaki3Kazuhiko Asai4Masako Koike5Shunichiro Tsuji6Fuminori Kimura7Takashi Murakami8Department of Obstetrics and Gynecology, Shiga University of Medical Science HospitalDepartment of Fetal-Maternal Medicine, Nagara Medical CenterDepartment of Fetal-Maternal Medicine, Nagara Medical CenterDepartment of Fetal-Maternal Medicine, Nagara Medical CenterDepartment of Fetal-Maternal Medicine, Nagara Medical CenterDepartment of Fetal-Maternal Medicine, Nagara Medical CenterDepartment of Obstetrics and Gynecology, Shiga University of Medical Science HospitalDepartment of Obstetrics and Gynecology, Shiga University of Medical Science HospitalDepartment of Obstetrics and Gynecology, Shiga University of Medical Science HospitalAbstract Background There is no established treatment for fetal growth restriction during pregnancy. We report two cases that represent an example of an amnioinfusion-based management strategy for severe fetal growth restriction with umbilical cord complications. Case presentation We encountered two cases of fetal growth restriction with abnormal fetal Doppler velocity. In one case, fetal ultrasound revealed a hypercoiled umbilical cord with a single umbilical artery and oligohydramnios, while fetal Doppler revealed a reversed end-diastolic flow in the umbilical artery and reversed a-waves of the ductus venosus. Umbilical cord compression was confirmed at 22 weeks and 2 days of gestation, and nine amnioinfusions were performed to relieve the umbilical cord compression. A cesarean section was performed at 31 weeks and 2 days of gestation because of severe preeclampsia. The Asian infant is now a normally developed 6-month-old. In another Asian case, fetal ultrasound revealed a hypercoiled cord, while fetal Doppler revealed a reversed end-diastolic flow in the umbilical artery and intermittent reversed a-waves of the ductus venosus. Umbilical cord compression was confirmed at 24 weeks and 5 days of gestation, and seven amnioinfusions were performed. A cesarean section was performed at 31 weeks and 1 day of gestation because of nonreassuring fetal status. At the age of 1 month, the Asian infant was stable on respiratory circulation. In both cases, fetal Doppler findings improved significantly following amnioinfusions. Conclusions Amnioinfusion is a symptomatic treatment for umbilical cord compression. However, to determine the therapeutic effect of amnioinfusion, complete resolution of the umbilical cord compression should be ascertained by ultrasonography.https://doi.org/10.1186/s13256-021-02904-4AmnioinfusionFetal growth restrictionOligohydramniosUmbilical cord compressionUmbilical cord factors |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Daisuke Katsura Yuichiro Takahashi Shigenori Iwagaki Rika Chiaki Kazuhiko Asai Masako Koike Shunichiro Tsuji Fuminori Kimura Takashi Murakami |
spellingShingle |
Daisuke Katsura Yuichiro Takahashi Shigenori Iwagaki Rika Chiaki Kazuhiko Asai Masako Koike Shunichiro Tsuji Fuminori Kimura Takashi Murakami Successful amnioinfusion for severe fetal growth restriction with umbilical cord complications: two case reports Journal of Medical Case Reports Amnioinfusion Fetal growth restriction Oligohydramnios Umbilical cord compression Umbilical cord factors |
author_facet |
Daisuke Katsura Yuichiro Takahashi Shigenori Iwagaki Rika Chiaki Kazuhiko Asai Masako Koike Shunichiro Tsuji Fuminori Kimura Takashi Murakami |
author_sort |
Daisuke Katsura |
title |
Successful amnioinfusion for severe fetal growth restriction with umbilical cord complications: two case reports |
title_short |
Successful amnioinfusion for severe fetal growth restriction with umbilical cord complications: two case reports |
title_full |
Successful amnioinfusion for severe fetal growth restriction with umbilical cord complications: two case reports |
title_fullStr |
Successful amnioinfusion for severe fetal growth restriction with umbilical cord complications: two case reports |
title_full_unstemmed |
Successful amnioinfusion for severe fetal growth restriction with umbilical cord complications: two case reports |
title_sort |
successful amnioinfusion for severe fetal growth restriction with umbilical cord complications: two case reports |
publisher |
BMC |
series |
Journal of Medical Case Reports |
issn |
1752-1947 |
publishDate |
2021-07-01 |
description |
Abstract Background There is no established treatment for fetal growth restriction during pregnancy. We report two cases that represent an example of an amnioinfusion-based management strategy for severe fetal growth restriction with umbilical cord complications. Case presentation We encountered two cases of fetal growth restriction with abnormal fetal Doppler velocity. In one case, fetal ultrasound revealed a hypercoiled umbilical cord with a single umbilical artery and oligohydramnios, while fetal Doppler revealed a reversed end-diastolic flow in the umbilical artery and reversed a-waves of the ductus venosus. Umbilical cord compression was confirmed at 22 weeks and 2 days of gestation, and nine amnioinfusions were performed to relieve the umbilical cord compression. A cesarean section was performed at 31 weeks and 2 days of gestation because of severe preeclampsia. The Asian infant is now a normally developed 6-month-old. In another Asian case, fetal ultrasound revealed a hypercoiled cord, while fetal Doppler revealed a reversed end-diastolic flow in the umbilical artery and intermittent reversed a-waves of the ductus venosus. Umbilical cord compression was confirmed at 24 weeks and 5 days of gestation, and seven amnioinfusions were performed. A cesarean section was performed at 31 weeks and 1 day of gestation because of nonreassuring fetal status. At the age of 1 month, the Asian infant was stable on respiratory circulation. In both cases, fetal Doppler findings improved significantly following amnioinfusions. Conclusions Amnioinfusion is a symptomatic treatment for umbilical cord compression. However, to determine the therapeutic effect of amnioinfusion, complete resolution of the umbilical cord compression should be ascertained by ultrasonography. |
topic |
Amnioinfusion Fetal growth restriction Oligohydramnios Umbilical cord compression Umbilical cord factors |
url |
https://doi.org/10.1186/s13256-021-02904-4 |
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