[Complications at the end of pregnancy and during labor due to hematoma of the umbilical cord].

One of the rare complications at the end of pregnancy and during birth is a haematoma of the umbilical cord with and without the subsequent rupturing of the umbilical cord. The characteristic symptom of this is intrauterine asphyxia. A haematoma of the umbilical cord is frequently fatal for the foetus. In selected cases it is possible to proved the existence of a haematoma. A brief description of the anatomy and physiology of the umbilical cord is followed by a discussion of the pathological or pathophysiological reasons for the onset of a haematoma of the umbilical cord. Two groups of factors are mentioned here, the mechanical and the dynamic changes of the blood vessels of the umbilical cord. This is followed by a description of two cases from the writer's own experience. In the first case the asphyxial after term infant died of pulmonary seventeen hours after birth; in the second case of the foetus had died in the uterus. The second case must be regarded as fatal. Dynamic factors affecting the umbilical cord had resulted in a rupture of the umbilical vein with a subsequent rupture of the umbilical sheath. In the first case the fact that the infant was overdue is discussed as a partial cause for the onset of the haematoma of the umbilical cord. This is one of the reasons why satisfactory ante natal care is considered essential, particularly towards the end of pregnancy.